Physician Assistant
KORDELL KOEPNICK PA
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1770289621 · enumerated 2023-02-02 · record updated 2026-05-05. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Mailing address 11504 PAINTBRUSH LN, POCATELLO, ID, 83202-5077 (208) 312-7630 Google Maps Apple Maps OpenStreetMap
- Practice location 500 S 8TH ST, BOISE, ID, 83702-7107 (855) 255-1750 Fax (855) 255-0905 Google Maps Apple Maps OpenStreetMap
Specialties
- Physician Assistant, Medical 363AM0700X · License PA-2450 ID
- Physician Assistant, Surgical 363AS0400X · License PA61460460 WA
- Physician Assistant 363A00000X · License PA219548 OR
- Physician Assistant, Medical 363AM0700X · License PA61460460 WA
- Physician Assistant, Medical 363AM0700X · License PA219548 OR
- Physician Assistant, Surgical 363AS0400X · License PA-2450 ID
- Physician Assistant, Surgical 363AS0400X · License PA219548 OR
- Physician Assistant 363A00000X · Primary · License PA-2450 ID
- Physician Assistant 363A00000X · License PA6140460 WA
In this directory
Locations and evidence
-
Practice location
BOISE, ID, 837027107
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.