Individual
SARAH ANGELA WILSON-KENNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1301 BARBARA JORDAN BLVD, SUITE 400, AUSTIN, TX 78723-3077
(512) 708-1234
Mailing address
1301 BARBARA JORDAN BLVD, SUITE 400, AUSTIN, TX 78723-3077
(512) 708-1234
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
678957
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329285601
—
TX
05
—
329285602
—
TX
Enumeration date
09/17/2006
Last updated
12/06/2016
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