| Doctor Name: | RAYNE KENNELLY |
| NPI Number: | 1225457666 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NPP |
| License Number: | NPP37862 |
| Business Practice Address: | 308 Callahan Rd North Kingstown, RI - 028527739 |
| Business Phone Number: | 4012959706 |
| Business Fax Number: | 4012950920 |
| Mailing Address: | Po Box 312, PASCOAG |
| State: | RI |
| Postal Code: | 028590312 |
| Phone Number: | 4015670800 |
| Fax Number: | 4015670900 |
| NPI Enumeration Date: | 04/14/2014 |
| NPI Last Update Date: | 04/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NPP37862 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |