Individual
KENNA HOGUE NETTLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, ATC
Contact information
Practice address
3719 DAUPHIN ST, MOBILE, AL 36608-1753
(251) 460-5333
(251) 460-5295
Mailing address
3719 DAUPHIN ST, MOBILE, AL 36608-1753
(251) 460-5333
(251) 460-5295
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA788
AL
Other
Enumeration date
01/16/2012
Last updated
01/16/2012
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