Provider Demographics
NPI:1346970324
Name:EYOLFSON, KELSEY ANN (PA)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ANN
Last Name:EYOLFSON
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:ANN
Other - Last Name:ROPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 191050
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83719-1050
Mailing Address - Country:US
Mailing Address - Phone:208-955-6500
Mailing Address - Fax:208-955-6501
Practice Address - Street 1:1474 N MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:KUNA
Practice Address - State:ID
Practice Address - Zip Code:83634-2041
Practice Address - Country:US
Practice Address - Phone:208-809-2885
Practice Address - Fax:208-809-2886
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant