KELLY A. STABENAU


Address: 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128
Phone: 2604583610

KELLY A. STABENAU (NPI# 1891219507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891219507
Entity Type Individual
Full Name KELLY A. STABENAU
Credential PA
Practice Address 7900 W Jefferson Blvd Ste 306
Fort Wayne
IN 46804-4128
Mailing Address 6920 Pointe Inverness Way Ste 200
Fort Wayne
IN 46804-7934
Practice Telephone 2604583610
Practice Fax Number 2604583611
Mailing Telephone 2604793514
Mailing Fax Number 2604793520
Enumeration Date 2017-08-03
Last Update Date 2020-09-30
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 10002268A IN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 7900 W JEFFERSON BLVD STE 306
City FORT WAYNE
State IN
Zip Code 46804-4128

Providers in the same location

NPI Name Taxonomy Address Enumeration
1164482303 Keith David Clancy Surgery 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 2006-03-23
1467019349 Ford W. Lee Nurse Practitioner 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 2019-05-25
1710462270 Brittony C. Rogers Nurse Practitioner 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 2018-10-01
1932688405 Matthew P. Cummins Physician Assistant 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 2018-08-07
1811485956 Dasmyn L. Dismuke Physician Assistant 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 2018-04-24
1467968172 Jamie D. Miller Physician Assistant 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 2017-12-18
1922521459 Neil J. Shorb Nurse Practitioner 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 2017-07-17
1093166738 Carolyn L. Hanrahan Physician Assistant 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 2016-06-23
1184099988 Molly M. Sabol Physician Assistant 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 2015-12-04
1124302633 Geoffrey A. Mccord Nurse Practitioner 7900 W Jefferson Blvd Ste 306, Fort Wayne, IN 46804-4128 2011-10-03
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1396350344 Derek Mumaw Physical Therapist 8420 Illinois Rd, Fort Wayne, IN 46804 2020-09-15
1942840228 Erin M Mason Behavior Technician 5601 Coventry Ln, Fort Wayne, IN 46804 2020-01-14
1346880879 Emily A Abdalla Behavior Technician 5601 Coventry Ln., Fort Wayne, IN 46804 2020-01-13
1083265433 Fort Wayne Endodontics Dentist 9407 Illinois Rd, Fort Wayne, IN 46804 2019-09-26
1689140949 Harrison Dental Group II, LLC Dentist 1333 Getz Rd, Fort Wayne, IN 46804 2018-10-15
1346731908 Erin Nicole Zimmerman Nurse Practitioner 10170 Illinois Rd # 14, Fort Wayne, IN 46804 2018-05-19
1417446022 Mary Harrington Physical Therapist 3320 Copper Hill Run, Fort Wayne, IN 46804 2018-05-09
1942701214 Joshawa Todd Torres Marriage & Family Therapist 5651 Coventry Ln # 116, Fort Wayne, IN 46804 2018-02-22
1194235408 Mitchell Kory Meyer Specialist/Technologist 9125 Yellow Tree Ct, Fort Wayne, IN 46804 2017-10-02
1902324916 Emily Rene Sagstetter Specialist/Technologist 6034 Liberty Glade Ct, Fort Wayne, IN 46804 2017-08-30
Find all providers in zip 46804

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

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, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104438944 Erin R Griffin Physician Assistant 5621 Woodshire Dr Apt 5, Fort Wayne, IN 46835-2959 2020-08-22
1821608209 Rebecca Coker Physician Assistant 5137 Truemper Way Apt 5, Fort Wayne, IN 46835-3252 2020-07-31
1114536844 Amanda Kohl Physician Assistant 5429 River Run Trl # 5, Fort Wayne, IN 46825-6039 2020-07-29
1538778352 Kiersten Michelle Coatney Physician Assistant 3924 Taylor Rd Apt 65, Fort Wayne, IN 46804-1945 2020-07-28
1013366905 Brianna Abbott Physician Assistant 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 2016-06-10
1972890093 Megan Bearman Physician Assistant 3640 New Vision Dr, Suite A, Fort Wayne, IN 46845-1717 2011-07-10
1114211729 Joel A Ruetz Physician Assistant 7619 W Jefferson Blvd, Fort Wayne, IN 46804-4133 2011-06-01
1568617256 Parkview Health System Inc Physician Assistant 11104 Parkview Circle Dr Ste 320, Fort Wayne, IN 46845-1733 2008-11-21
1841441805 Brooke B Kutka Physician Assistant 2512 East Dupont Rd, Suite 200, Fort Wayne, IN 46825-1609 2008-10-08
1265688808 Kali E Veness Physician Assistant 2930 Lake Ave, Fort Wayne, IN 46805-5416 2008-08-14
Find all providers in FORT WAYNE

Competitor

Search similar providers

City FORT WAYNE
Zip Code 46804

Improve Information

Please comment or provide details below to improve the information on KELLY A. STABENAU.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches