Provider Demographics
NPI:1902823537
Name:RAMEY, KENNETH (PA-C)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:RAMEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10620 SPOTSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-2637
Mailing Address - Country:US
Mailing Address - Phone:540-710-1086
Mailing Address - Fax:540-710-1126
Practice Address - Street 1:10620 SPOTSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-2637
Practice Address - Country:US
Practice Address - Phone:540-710-1086
Practice Address - Fax:540-710-1126
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110840811363A00000X
NC02814363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P52967Medicare UPIN
VA970000606Medicare PIN