MEDICARE: KRISTEN DENNEHY PA

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	PA14323	TX
2	390200000X	Student in an Organized Health Care Education/Training Program		AZ

General Provider Information

NPI Number	:	1952861106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN DENNEHY PA

Provider Business Mailing Address
First Line	:	2423 WILLIAMS DR STE 107
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78628-3269
Country	:	US
Telephone Number	:	877-800-5722
Fax Number	:

Provider Business Practice Location Address
First Line	:	3950 N A W GRIMES BLVD STE N104
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-3540
Country	:	US
Telephone Number	:	877-800-5722
Fax Number	:

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

Provider Enumeration Date	:	03/23/2019
Last Update Date	:	03/19/2026

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Directions to “ KRISTEN DENNEHY PA” Practice Location

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