Individual
KELLI KRISTINA HUESMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 WYOMING ST, SUITE 3272, DAYTON, OH 45409-2722
(937) 208-6790
(937) 208-6797
Mailing address
1 WYOMING ST, SUITE 3272, DAYTON, OH 45409-2722
(937) 208-6790
(937) 208-6797
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001917
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067486
—
OH
Enumeration date
07/05/2006
Last updated
12/26/2013
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