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NPI 1588487201

NPI 1588487201 : KIRSTEN KINSEY ENGELKE PA-C : DALLAS, TX

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General NPI Number Information
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    NPI Number           |    1588487201
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    Entity Type          |    Individual 
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    Provider Name        |    KIRSTEN KINSEY ENGELKE PA-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/01/2024
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    Last Update Date     |    12/16/2024
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Provider Practice Location Address
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    Address Line         |    8200 WALNUT HILL LN 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75231-4402
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    Country              |    US
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    Telephone            |    469-964-8732
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2204 WATERSTONE TRL 
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    City                 |    FLOWER MOUND
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    State                |    TX
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    Zip                  |    75028-6232
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    Country              |    US
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    Telephone            |    
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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       |    1225728
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    License Number State |    TX
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