Individual
MS. KELLY JEANNE HENGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0110004802
VA
207R00000X
Internal Medicine Physician
0110004802
VA
363AM0700X
Medical Physician Assistant
Primary
0110-004802
VA
Other
Enumeration date
12/11/2008
Last updated
07/02/2019
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