| Doctor Name: | CAROLYN LANEY KENNEDY |
| NPI Number: | 1932177581 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN 9200370 |
| Business Practice Address: | 2475 Garrison Ave Port St Joe, FL - 324565265 |
| Business Phone Number: | 8502299710 |
| Business Fax Number: | 8502271794 |
| Mailing Address: | 2017 Marvin Ave, PORT ST JOE |
| State: | FL |
| Postal Code: | 324562050 |
| Phone Number: | 8502273340 |
| Fax Number: | |
| NPI Enumeration Date: | 03/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | RN 9200370 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |