| Doctor Name: | MS. JACQUELINE F KENNEDY |
| NPI Number: | 1609877653 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 169562 |
| Business Practice Address: | 181 State Rd Whately, MA - 01093 |
| Business Phone Number: | 4136650176 |
| Business Fax Number: | 4136650176 |
| Mailing Address: | P.o. Box 205, WHATELY |
| State: | MA |
| Postal Code: | 01093 |
| Phone Number: | 4136650176 |
| Fax Number: | 4133979760 |
| NPI Enumeration Date: | 08/02/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 169562 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |