Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Audra Lynn Wilson, PAC

Individual provider Physician Assistant · NPI 1336734789

Audra Lynn Wilson, PAC is a Physician Assistant in Boise, Idaho. Graduated from Des Moines University of Osteopathic Medicine and Health Sciences in 2022, 4 years ago. Practices with Kelly Bridges Neurosurgery PLLC, a 2-clinician group and accepts Medicare assignment. Licensed in Idaho and Washington.

Years since qualifying
4
Trained at
Des Moines University of Osteopathic Medicine and Health Sciences
Licensed in
ID, WA
In the registry since
2021
Specialties on file
3
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

6140 W Curtisian Ave Ste 400
Boise, ID 83704-8907
Phone: (208) 327-5600
Fax: (208) 327-5602
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1661274 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA61338060 (WA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA61338060 (WA)

Record details

NPI number1336734789
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedMarch 8, 2021
Last updated in NPPESDecember 10, 2024
Certification dateDecember 10, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolDES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Graduated 2022 (4 years in practice)
Group practice Kelly Bridges Neurosurgery Pllc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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