Provider Demographics
NPI:1104922723
Name:ABNEY, KENNETH NELSON
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:NELSON
Last Name:ABNEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6593 TRAILVIEW CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-1200
Mailing Address - Country:US
Mailing Address - Phone:513-759-9307
Mailing Address - Fax:513-759-9307
Practice Address - Street 1:6593 TRAILVIEW CT
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-1200
Practice Address - Country:US
Practice Address - Phone:513-759-9307
Practice Address - Fax:513-759-9307
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical