# ABBIE LYN SIEBENHAAR

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1295003234
- **Gender:** F
- **Credential:** PAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 9505091-1206 | UT | — |
| 363AM0700X | Medical Physician Assistant | 9505091-1206 | UT | Yes |

## Other

- **Enumeration date:** 12/05/2011
- **Last updated:** 10/14/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5059 | AZ LIC | AZ |
| 01 | — | 9505091-1206 | UT LICENSE | UT |