Tisha M Kennebeck in Oshkosh - Physician Assistant
Tisha M Kennebeck - NPI 1710094248
Tisha M Kennebeck is a Physician Assistant in Oshkosh, Wisconsin. Tisha M Kennebeck practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Tisha M Kennebeck is 1710094248. The last update date is 2023-03-07.
Tisha M Kennebeck's current location address is 414 Doctors Ct, Oshkosh, Wisconsin. You can contact this provider via phone number 9203038700 and fax number 9203035004. The mailing address for Tisha M Kennebeck is 414 Doctors Ct, Oshkosh, Wisconsin. To know further, please read the information below!
Provider Profile Detail
Provider Name | Tisha M Kennebeck |
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Address | 414 Doctors Ct, Oshkosh, Wisconsin |
Phone Number | 9203038700 |
Fax Number | 9203035004 |
Sole Proprietor | N |
Credentials | PA-C |
NPI Number Detail
NPI Number | 1710094248 |
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Provider Enumeration Date | 2006-08-23 |
Last Updated Date | 2023-03-07 |
Provider Mailing Address Detail
Address | 414 Doctors Ct |
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City | Oshkosh |
State | Wisconsin (WI) |
Post Code | 54901 |
Phone Number | 9203038700 |
Fax Number | 9203035004 |
Provider's Primary Taxonomy Detail
Speciality | Physician Assistant |
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Taxonomy | 363A00000X |
Licence No | 1085-023 |
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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42975400 | WI | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Tisha M Kennebeck?
The Tisha M Kennebeck has been issued the NPI (National Provider Identifier) 1710094248 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete street address where Tisha M Kennebeck is physically located?
The Tisha M Kennebeck is physically situated at the following address: 414 Doctors Ct, Oshkosh, WI, 54901.
What is the Tisha M Kennebeck's specialty and taxonomy code?
The Tisha M Kennebeck's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
When did the Tisha M Kennebeck receive its 1710094248?
The Tisha M Kennebeck was issued its 1710094248 on 2006-08-23, which is the date when the organization was assigned this unique identifier.
As of what date were the details pertaining to Tisha M Kennebeck last refreshed?
The information related to the Tisha M Kennebeck, including its address, specialty, and other relevant details, was last updated on 2023-03-07.