Kenneth Lynn Hussey, PA-C
Individual provider Active NPI Medical Physician Assistant · Beaver, UT
NPI 1841295938 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1841295938
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 3434871206 (UT)
- Practice address
- 1059 N 100 W
Beaver, UT 84713-1690 - Phone
- (435) 438-7280
- Fax
- (435) 438-7210
- NPI assigned
- Jun 16, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3434871206 | UT | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 3434871206 | UT | Yes |
Addresses
Primary practice location
1059 N 100 W
Beaver, UT 84713-1690
Mailing address
PO Box 1690
Beaver, UT 84713-1690
Phone (435) 438-7280
Other providers in Beaver, UT
- H2RX
- Lisa Dawn Hendrickson
- Travis Hicks
- Wade Hollingshead
- David S Howard
- Brennon K Hutchings
- Steven R Hutchings
- Scott Anthony Langford
- Colby Limb
- Paul L Marshall
All providers in Beaver, UT · Medical Physician Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.