Provider Demographics
NPI:1942981477
Name:WINEBARGER, KALEB (PA)
Entity type:Individual
Prefix:
First Name:KALEB
Middle Name:
Last Name:WINEBARGER
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:4842 N CORTONA WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-1913
Mailing Address - Country:US
Mailing Address - Phone:208-579-2024
Mailing Address - Fax:
Practice Address - Street 1:4842 N CORTONA WAY
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-1913
Practice Address - Country:US
Practice Address - Phone:208-579-2024
Practice Address - Fax:208-579-2029
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2025-08-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant