Individual
KELLY WENTZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1407 W BADDOUR PKWY, LEBANON, TN 37087-2513
(615) 444-6203
Mailing address
1407 W BADDOUR PKWY, LEBANON, TN 37087-2513
(615) 444-6203
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
327683
NC
363A00000X
Physician Assistant
Primary
3405
TN
Other
Enumeration date
10/26/2017
Last updated
04/24/2025
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