Individual
KENDALL WASZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4915 NORTON HEALTHCARE BLVD STE 301, LOUISVILLE, KY 40241-2866
(502) 635-7455
(502) 634-9296
Mailing address
1169 EASTERN PKWY STE 2265, LOUISVILLE, KY 40217-1479
(502) 635-7455
(502) 634-9296
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2365
KY
363AM0700X
Medical Physician Assistant
PA2365
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA2365
KENTUCKY PHYSICIAN ASSISTANT LICENSE
KY
Enumeration date
11/22/2013
Last updated
08/17/2023
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