Individual provider · Type 1 NPI

Grace Kenville, PA-C

Medical Physician Assistant · Philadelphia, PA

NPI number 1902625866 Active

Practice location

5501 Old York Rd
Philadelphia, PA 19141-3018

Call (215) 456-7890 Map

Mailing address

24 Saxony Dr
Cinnaminson, NJ 08077-4390

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XMA066123 (PA)

Medical Physician Assistant: Definition to come...

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About NPI 1902625866

Grace Kenville, PA-C's National Provider Identifier is 1902625866, issued on Oct 8, 2024. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Philadelphia, PA. The record was last updated on Oct 8, 2024.