Provider Demographics
NPI:1750753406
Name:KENNEL, KARI (FNP)
Entity type:Individual
Prefix:MS
First Name:KARI
Middle Name:
Last Name:KENNEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:
Other - Last Name:EGLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 844273
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4273
Mailing Address - Country:US
Mailing Address - Phone:903-535-9041
Mailing Address - Fax:
Practice Address - Street 1:1001 N PALESTINE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-4122
Practice Address - Country:US
Practice Address - Phone:903-904-5084
Practice Address - Fax:903-904-5085
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129268363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner