MS. Tisha M Kennebeck, PA-C

NPI #1710094248 in Oshkosh, Wisconsin

Provider Information

NPI Number: 1710094248
Entity Type: Individual
Name: MS. Tisha M Kennebeck, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Aug 23, 2006
Last Updated: Nov 11, 2025

Practice Location

Address: 414 DOCTORS CT
City: Oshkosh
State: Wisconsin
ZIP Code: 54901
Phone: (920) 303-8700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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