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Individual
MRS. LESLIE HAMMETT KENNEDY
Active
Individual
MRS. LESLIE HAMMETT KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
77079
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7004720
—
NC
01
—
AA54583365
MEDICARE PIN
SC
01
—
AA54585019
MEDICARE PIN
SC
01
—
AA54586067
MEDICARE PIN
SC
01
—
AA54589068
MEDICARE PIN
SC
01
—
AA54589225
MEDICARE PIN
SC
05
—
NP1936
—
SC
Enumeration date
03/17/2010
Last updated
04/26/2022
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