Individual
KATHLEEN WHITE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
75 CLAREMONT ST STE A, KALISPELL, MT 59901-3500
(406) 752-8282
Mailing address
350 HERITAGE WAY, SUITE 1300, KALISPELL, MT 59901-3158
(406) 752-5170
(406) 752-5120
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
266
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432610
—
MT
01
—
95503
BLUE CROSS
MT
Enumeration date
05/24/2006
Last updated
11/27/2023
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