Individual
MRS. KATELYN ELYSE MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
808 CLEVELAND BLVD, CALDWELL, ID 83605-4168
(208) 459-1025
(208) 466-5359
Mailing address
PO BOX 9, NAMPA, ID 83653-0009
(208) 467-4431
(208) 466-5359
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1809
ID
Other
Enumeration date
10/21/2019
Last updated
05/05/2021
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