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NPI Code Detail

MEDICARE: KENDALL KATHERINE HANAK PA-S

MEDICARE: KENDALL KATHERINE HANAK PA-S
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
1363A00000XPhysician Assistant11429AZ

General Provider Information

NPI Number : 1871334193
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDALL KATHERINE HANAK PA-S
Provider Business Mailing Address
First Line : 865 N ARIZOLA RD
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85122-6011
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 865 N ARIZOLA RD
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85122-6011
Country : US
Telephone Number : 520-836-3446
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2024
Last Update Date : 12/08/2025

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Directions to “ KENDALL KATHERINE HANAK PA-S” Practice Location

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