Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KENNETH NICLEY, PA
ActiveMR. KENNETH NICLEY, PA is a Physician Assistant healthcare provider located in MAYNARDVILLE, Tennessee. NPI 1306252598 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · MAYNARDVILLE, TN
Registration Details
- NPI Number
- 1306252598
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 8, 2014 (12.117617449364 yrs)
- Last Updated
- Jan 21, 2015
- License
-
2416 (TN)
Practice Information
- Address
-
149 DURHAM DRMAYNARDVILLE, TN, 378072925Browse TN providers · Browse ZIP 37807
- Phone
- 8659922221
- Fax
- 8659922251
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in MAYNARDVILLE, TN
| Name | Credential | NPI |
|---|---|---|
| MS. PAULA RENEE MIKSA | PA-C | 1548209463 |
| HOLLY APODACA | PA-C | 1770872087 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.