# KENNEDY FAMILY MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487415170
- **Authorized official:** CRYSTAL N KENNEDY NP (OWNER OPERATOR)
- **Authorized official phone:** (260) 222-1181

## Contact information

- **Practice address:** 1153 W 15TH ST, AUBURN, IN 46706-2061
- **Practice address phone:** (260) 222-1181
- **Practice address fax:** (260) 270-2800
- **Mailing address:** 1153 W 15TH ST, AUBURN, IN 46706-2061
- **Mailing address phone:** (260) 222-1181
- **Mailing address fax:** (260) 270-2800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/19/2024
- **Last updated:** 01/23/2024