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General NPI Number Information
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NPI Number | 1295326882
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Entity Type | Individual
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Provider Name | SARAH KENNY PA
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Gender | Female
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 4455 DUNCAN AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1111
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Country | US
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Telephone | 972-322-5695
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Fax |
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Provider Business Mailing Address
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Address Line | 341 LOWLINE DR
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City | CLARKSVILLE
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State | TN
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Zip | 37043-3025
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Country | US
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Telephone | 972-322-5695
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA14271
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085.010790
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 6125
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2024038955
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License Number State | MO
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