Janelle L Kyllo Bouchie, PA-C
Janelle L Kyllo Bouchie, PA-C is a Physician Assistant in Detroit Lakes, Minnesota. Qualified in 2018, 8 years ago. Practices with St Marys Regional Health Center, a 188-clinician group and accepts Medicare assignment. Licensed in Idaho and Minnesota.
- Years since qualifying
- 8
- Licensed in
- ID, MN
- In the registry since
- 2012
- Specialties on file
- 2
What do these letters mean?
- PA-C — Physician Assistant, Certified
- A physician assistant who holds current national certification.
Practice location Address checks out
1027 Washington AveDetroit Lakes, MN 56501-3409
Phone: (218) 847-5611
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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 12809 (MN) |
|---|---|
| Pediatric Occupational Therapist | Taxonomy 225XP0200X · Licence OT-1120 (ID) |
Record details
| NPI number | 1366716102 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | PA-C |
| Sole proprietor | No |
| NPI enumerated | February 24, 2012 |
| Last updated in NPPES | November 10, 2021 |
| Certification date | November 10, 2021 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2018 (8 years in practice) |
| Group practice | St Marys Regional Health Center — 188 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
Other providers in Detroit Lakes
-
Mrs. Diane Jean McCormack, MS, OTR/L
15840 Long Lake Rd, Detroit Lakes, MN 56501 · (218) 847-5071