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Individual
KATE ELLEN KENNEDY
Active
Individual
KATE ELLEN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30005602
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005867
—
WA
01
—
284940
INTERNAL ID-MOTOR VEHICLE ID
—
01
—
G8866114
MEDICARE PTAN
WA
01
—
G8921537
MEDICARE PTAN
WA
Enumeration date
11/06/2006
Last updated
10/29/2021
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