Provider Demographics
NPI:1649633454
Name:KENNEY, ALLISON VALERIE (PA-C, OTR)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:VALERIE
Last Name:KENNEY
Suffix:
Gender:F
Credentials:PA-C, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 RIVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-1236
Mailing Address - Country:US
Mailing Address - Phone:248-613-9791
Mailing Address - Fax:
Practice Address - Street 1:830 W HIGH ST STE 360
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3985
Practice Address - Country:US
Practice Address - Phone:248-613-9791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant