person
Kelly Ashley Boardman, PA-C
Medical Physician Assistant in Leesburg, Virginia
NPI 1821492067

Kelly Ashley Boardman is a Medical Physician Assistant based in Herndon, VA and is specialized in Medical. Kelly Ashley Boardman practices in Leesburg, VA and has the professional credentials of PA-C. The NPI Number for Kelly Ashley Boardman is 1821492067 and holds a License No. 0110004747 (Virginia).

The current practice location address for Kelly Ashley Boardman is 19415 Deerfield Ave, Leesburg, VA and can be reached out via phone at 703-729-9220 and via fax at 703-858-3529. You can also correspond with Kelly Ashley Boardman through the mailing address at 2623 PURITAN CT, HERNDON, VA - 20171-2439 (mailing address contact number: 404-326-2826).

Location: 19415 Deerfield Ave, Leesburg, VA, 20171-2439
person
Provider Profile Details
NPI Number
1821492067
Provider Name
Kelly Ashley Boardman
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
19415 Deerfield Ave, Leesburg, VA, 20171-2439
Phone Number
703-729-9220
Fax Number
703-858-3529
Provider Enumeration Date
10/17/2014
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1821492067 05 VA
30016805880001 05 VA
institution
Provider Business Practice Location Address Details
Address
19415 Deerfield Ave
City
State
Zip
20176-8452
Phone Number
703-729-9220
Fax Number
703-858-3529
person
Provider Business Mailing Address Details
Address
2623 Puritan Ct
City
State
Zip
20171-2439
Phone Number
404-326-2826
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
0110004747 (Virginia)
Definition
Definition to come...
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