Provider Demographics
NPI:1205090164
Name:KABAT, VANESSA R (PA-C)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:R
Last Name:KABAT
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4804 LEAVITT RD
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-2382
Mailing Address - Country:US
Mailing Address - Phone:440-989-2066
Mailing Address - Fax:440-989-1153
Practice Address - Street 1:5001 TRANSPORTATION DR STE 101
Practice Address - Street 2:
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44054-2850
Practice Address - Country:US
Practice Address - Phone:440-329-2800
Practice Address - Fax:440-329-2810
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2021-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH50.002702363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant