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Individual
CECIL A VANDENABEELE
Active
Individual
CECIL A VANDENABEELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01004
KS
363AM0700X
Medical Physician Assistant
1501004
KS
363AM0700X
Medical Physician Assistant
2005003645
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396827267
—
MO
Enumeration date
10/20/2006
Last updated
12/07/2018
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