Provider Demographics
NPI:1881358414
Name:DAHLENBURG, KENADEY ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:KENADEY
Middle Name:ROSE
Last Name:DAHLENBURG
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:12095 COUNTY ROAD 1060
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73047-9554
Mailing Address - Country:US
Mailing Address - Phone:405-368-7831
Mailing Address - Fax:
Practice Address - Street 1:112 E LUELLEN RD
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:OK
Practice Address - Zip Code:73047-9524
Practice Address - Country:US
Practice Address - Phone:833-274-4174
Practice Address - Fax:833-274-4178
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2023-06-20
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant