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Individual

MISS ISABELLE MARIE KIM KALLENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
620 19TH ST S, BIRMINGHAM, AL 35233
(334) 750-8965
Mailing address
5287 OLD MILL RUN, TRUSSVILLE, AL 35173-2603
(334) 750-8965

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14015
GA
363A00000X
Physician Assistant
1594
AL
363AM0700X
Medical Physician Assistant
AL

Other

Enumeration date
03/06/2020
Last updated
05/14/2026
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