Individual provider · Type 1 NPI

Tisha M. Kennebeck, PA-C

Physician Assistant · Oshkosh, WI

NPI number 1710094248 Active

Practice location

414 Doctors Ct
Oshkosh, WI 54901

Call (920) 303-8700 Map

Fax (920) 303-5004

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X1085-023 (WI)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1710094248

Tisha M. Kennebeck, PA-C's National Provider Identifier is 1710094248, issued on Aug 23, 2006. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Oshkosh, WI. The record was last updated on Nov 11, 2025.