| Doctor Name: | MS. KERRY MARIE KENNEDY |
| NPI Number: | 1083949986 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP |
| License Number: | R123669 |
| Business Practice Address: | 2250 Nw 26th St Owatonna Hospital Owatonna, MN - 55060 |
| Business Phone Number: | 5074557644 |
| Business Fax Number: | 5074446053 |
| Mailing Address: | 610 Florence Ave, OWATONNA |
| State: | MN |
| Postal Code: | 550604704 |
| Phone Number: | 5074512630 |
| Fax Number: | |
| NPI Enumeration Date: | 10/09/2009 |
| NPI Last Update Date: | 03/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | R123669 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |