Individual
MR. ABRAHAM JOSEPH KIESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Mailing address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10004516A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10004516A
INDIANA LICENSE
IN
01
—
1222091
BOARD CERTIFICATION
IN
05
—
300096298
—
IN
05
—
7101011410
—
KY
Enumeration date
07/30/2024
Last updated
10/30/2024
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