Individual
SHIVALI KANAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1720 NICHOLASVILLE RD STE 500, LEXINGTON, KY 40503-1487
(859) 278-1114
(859) 277-0541
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6200
(859) 258-6203
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085009409
IL
363A00000X
Physician Assistant
Primary
PA3464
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7101021470
—
KY
Enumeration date
09/28/2020
Last updated
12/13/2024
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