Individual
WADE ALAN KENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2020
SC
363AS0400X
Surgical Physician Assistant
PA 9104209
FL
Other
Enumeration date
08/14/2007
Last updated
01/15/2026
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