MEDICARE: KIRSTEN M AHNELL PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA224	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000598650	OTHER	KY	BCBS #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215172721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSTEN M AHNELL PA-C

Provider Business Mailing Address
First Line	:	2211 MAYFAIR DR STE 102
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-4569
Country	:	US
Telephone Number	:	270-688-1352
Fax Number	:	270-683-4313

Provider Business Practice Location Address
First Line	:	2211 MAYFAIR DR STE 102
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-4569
Country	:	US
Telephone Number	:	270-688-1352
Fax Number	:	270-683-4313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2008
Last Update Date	:	07/21/2022

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Directions to “ KIRSTEN M AHNELL PA-C” Practice Location

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