Provider Demographics
NPI:1326884560
Name:VON KAENEL, CHRISTOPHER RYAN (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:RYAN
Last Name:VON KAENEL
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:3224 RUNNING DEER CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-6510
Mailing Address - Country:US
Mailing Address - Phone:949-421-9979
Mailing Address - Fax:
Practice Address - Street 1:1220 MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSONVLLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3725
Practice Address - Country:US
Practice Address - Phone:812-282-6631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant