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Individual

KELLEY WOLFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1000 E PARK BLVD STE 120, BOISE, ID 83712-7793
(208) 381-4100
(208) 381-4101
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-639
ID
363A00000X
Physician Assistant
Primary
PA639
ID

Other

Enumeration date
10/06/2006
Last updated
02/04/2026
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