Individual
KELLY HOOSE
Active
Individual
KELLY HOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.0006318
CO
363AS0400X
Surgical Physician Assistant
Primary
PA.0006318
CO
Other
Enumeration date
10/14/2020
Last updated
10/25/2023
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