| Doctor Name: | MR. MICHAEL DEE KENNEDY |
| NPI Number: | 1235386004 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP |
| License Number: | ARNP9206905 |
| Business Practice Address: | 310 E Byrd Ave Suite B Bonifay, FL - 324253068 |
| Business Phone Number: | 8505474440 |
| Business Fax Number: | 8505474441 |
| Mailing Address: | 310 E Byrd Ave, Suite B BONIFAY |
| State: | FL |
| Postal Code: | 324253068 |
| Phone Number: | 8505474440 |
| Fax Number: | 8505474441 |
| NPI Enumeration Date: | 08/25/2008 |
| NPI Last Update Date: | 01/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | ARNP9206905 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |