Kilstrom, Jonathan L.

Kilstrom, Jonathan L. is an individual health care provider with primary practice located at 933 E Pierce St , Council Bluffs IA 51503-4626. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Kilstrom, Jonathan L. can be contacted via phone (712) 396-6111.

Contact Information

Primary practice address
933 E Pierce St Council Bluffs IA 51503-4626
Phone: (712) 396-6111
Fax: (712) 396-7026
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA09172 Texas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 081384 Iowa

Profile Details

NPI number 1740695899
LBN Legal business name Kilstrom, Jonathan L.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2014
Last updated Oct 2nd, 2019 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1740695899 NPPES
Iowa MEDICAID 1740695899
Iowa MEDICAID 420680355-12

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