Individual
MRS. KELLY K. SIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
Mailing address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-2267
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA313
WY
363AM0700X
Medical Physician Assistant
PA313
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106133017
—
WY
Enumeration date
06/20/2006
Last updated
05/29/2024
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