Ketelsen, Candice

Ketelsen, Candice is an individual health care provider with primary practice located at 2500 W A St Ste 101 , Moscow ID 83843-6000. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Ketelsen, Candice can be contacted via phone (208) 882-0540.

Contact Information

Primary practice address
2500 W A St Ste 101 Moscow ID 83843-6000
Phone: (208) 882-0540
Fax: (208) 883-1853
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60758102 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-1496 Idaho

Profile Details

NPI number 1073040515
LBN Legal business name Ketelsen, Candice
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2017
Last updated Jul 19th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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