Individual
KELSEY WIELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3320 N MILWAUKEE ST STE 180, BOISE, ID 83704-0726
(208) 615-4858
Mailing address
810 HEARTLAND CT, NAMPA, ID 83686-8155
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
196792
—
Other
Enumeration date
03/17/2026
Last updated
03/17/2026
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