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Individual

MR. KELLEN AARON NOLD

Active
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Individual

MR. KELLEN AARON NOLD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00270600
NJ
363AS0400X
Surgical Physician Assistant
Primary
PA60373777
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1851676118
WA
01
P01229427
RAILROAD
WA
Enumeration date
10/19/2011
Last updated
12/06/2013
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