Provider Demographics
NPI:1366676496
Name:SENTELL, KATHLEEN C (PAC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:C
Last Name:SENTELL
Suffix:
Gender:F
Credentials:PAC
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5295 PRESERVE PKWY
Mailing Address - Street 2:SUITE 270
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4701
Mailing Address - Country:US
Mailing Address - Phone:205-949-9289
Mailing Address - Fax:205-949-9290
Practice Address - Street 1:5295 PRESERVE PKWY
Practice Address - Street 2:SUITE 270
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4701
Practice Address - Country:US
Practice Address - Phone:205-949-9289
Practice Address - Fax:205-949-9290
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALPA565363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical