Kyllo Bouchie, Janelle L

Kyllo Bouchie, Janelle L is an individual health care provider with primary practice located at 1027 Washington Ave , Detroit Lakes MN 56501-3409. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Kyllo Bouchie, Janelle L can be contacted via phone (218) 847-5611.

Contact Information

Primary practice address
1027 Washington Ave Detroit Lakes MN 56501-3409
Phone: (218) 847-5611
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT-1120 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 12809 Minnesota

Profile Details

NPI number 1366716102
LBN Legal business name Kyllo Bouchie, Janelle L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2012
Last updated Nov 10th, 2021 - about 4 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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