Individual
ANGELA M KEHLENBRINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2088
(208) 381-2893
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003079A
IN
363A00000X
Physician Assistant
3771758
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300046601
—
IN
Enumeration date
09/09/2020
Last updated
05/21/2025
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