| Doctor Name: | DR. JENNIFER NICOLE KENNEDY |
| NPI Number: | 1609089143 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | 554 |
| Business Practice Address: | Bldg 1058 Barkley Rd Diraimondo West - Aviation Medicine Clinic Fort Carson, CO - 80913 |
| Business Phone Number: | 7195265499 |
| Business Fax Number: | |
| Mailing Address: | 1650 Cochrane Cir Bldg 7505, FORT CARSON |
| State: | CO |
| Postal Code: | 809134613 |
| Phone Number: | 7195269500 |
| Fax Number: | |
| NPI Enumeration Date: | 05/08/2007 |
| NPI Last Update Date: | 01/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 554 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |