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Individual
MR. BRIAN KENNEDY
Active
Individual
MR. BRIAN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NAVIGATOR
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
3286250-1999
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024869940002
—
PA
Enumeration date
09/28/2022
Last updated
09/28/2022
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