Provider Demographics
NPI:1780455139
Name:VILES, ABIGAIL (PA)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:VILES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:HORNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6822 N FLORA AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-2873
Mailing Address - Country:US
Mailing Address - Phone:636-357-6889
Mailing Address - Fax:
Practice Address - Street 1:15319 W 95TH ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1262
Practice Address - Country:US
Practice Address - Phone:913-538-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty