Individual
KATRINA M. MCKELLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
209 FOREST ST, MCCALL, ID 83638-5256
(208) 634-2225
Mailing address
209 FOREST ST, MCCALL, ID 83638-5256
(208) 634-2225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-1268
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
WA
Other
Enumeration date
07/15/2015
Last updated
05/25/2019
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