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Individual

KELLIE ANNE HANSEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4610 KANAWHA AVE SW STE 200, SOUTH CHARLESTON, WV 25309-1367
(304) 388-1724
(304) 205-7739
Mailing address
4610 KANAWHA AVE SW STE 200, SOUTH CHARLESTON, WV 25309-1367
(304) 388-1724
(304) 205-7739

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1080
WV
363AM0700X
Medical Physician Assistant
Primary
1080
WV

Other

Enumeration date
01/26/2006
Last updated
03/12/2024
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