Doctor Name: | DONNA L KENNEDY |
NPI Number: | 1699737130 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R045246 |
Business Practice Address: | 110 Broadway Bucksport, ME - 04416 |
Business Phone Number: | 2074697371 |
Business Fax Number: | 2074697306 |
Mailing Address: | P O Box 447, BUCKSPORT |
State: | ME |
Postal Code: | 04416 |
Phone Number: | 2074697371 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R045246 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |