Antoine, Kenneth

Antoine, Kenneth is an individual health care provider with primary practice located at 510 E Clinton Ave , Athens TX 75751-3410. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Antoine, Kenneth can be contacted via phone (903) 675-3202.

Contact Information

Primary practice address
510 E Clinton Ave Athens TX 75751-3410
Phone: (903) 675-3202
Fax: (903) 677-5586
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 649939 Texas

Profile Details

NPI number 1548259674
LBN Legal business name Antoine, Kenneth
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Apr 7th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548259674 NPPES
Texas MEDICAID 0068546-02

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