Provider Demographics
NPI:1467668160
Name:ENSMINGER, KERRY (PA)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:ENSMINGER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 741331
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1331
Mailing Address - Country:US
Mailing Address - Phone:913-469-0503
Mailing Address - Fax:913-469-5267
Practice Address - Street 1:801 N MUR LEN RD
Practice Address - Street 2:STE 201
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1794
Practice Address - Country:US
Practice Address - Phone:913-451-2253
Practice Address - Fax:913-338-1311
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2022-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS15-00766363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant