Organization Name: | K L KENNEDY LLC |
NPI Number: | 1467798702 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAREN L KENNEDY-EVANS (PRESIDENT) |
Mailing Address: | 5090 N Corte De Catalonia Tucson |
State: | AZ US |
Postal Code: | 857186078 |
Phone Number: | 5202321019 |
Fax Number: | 5202991680 |
NPI Enumeration Date: | 12/13/2012 |
NPI Last Update Date: | 12/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | RN122326 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |