Provider Demographics
NPI:1801119771
Name:ELSENBROEK, KERBI DAWN (PA)
Entity type:Individual
Prefix:
First Name:KERBI
Middle Name:DAWN
Last Name:ELSENBROEK
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Gender:F
Credentials:PA
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Mailing Address - Street 1:7920 IRISH DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-5741
Mailing Address - Country:US
Mailing Address - Phone:817-800-1416
Mailing Address - Fax:
Practice Address - Street 1:12469 TIMBERLAND BLVD # 501
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6548
Practice Address - Country:US
Practice Address - Phone:817-431-6555
Practice Address - Fax:817-431-7979
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2018-09-18
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant