# KATHRYN R. HENNESSEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1649215971
- **Gender:** F
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OS007723L | PA | Yes |

## Other

- **Enumeration date:** 06/19/2006
- **Last updated:** 02/09/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0013910420002 | — | PA |
| 01 | — | 0279841000 | IBC - PC/KHPE | PA |
| 01 | — | 1089445 | CIGNA HMO/PPO | PA |
| 01 | — | 10928555 | CAQH ID\# | PA |
| 01 | — | 16452-OS007723L | HEALTH PARTNERS | PA |
| 01 | — | 195050 | HIGHMARK BLUE SHIELD | PA |
| 01 | — | 30019705 | KEYSTONE MERCY | PA |
| 01 | — | 4358937 | AETNA PPO | PA |
| 01 | — | P00186614 | RRM | PA |