# LYNNETTE D HANSEN KENNISON PA

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

## Provider details

- **NPI number:** 1699945576
- **Authorized official:** LYNETTE HANSEN KENNISON PH D ARPN (OWNER)
- **Authorized official phone:** (904) 296-3113

## Contact information

- **Practice address:** 6817 SOUTHPOINT PKWY STE 304, JACKSONVILLE, FL 32216-6287
- **Practice address phone:** (904) 296-3113
- **Practice address fax:** (904) 296-3144
- **Mailing address:** 12484 MASTERS RIDGE DR, JACKSONVILLE, FL 32225-5758
- **Mailing address phone:** (904) 982-7060
- **Mailing address fax:** (904) 269-3144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | ARNP1117892 | FL | Yes |

## Other

- **Enumeration date:** 03/06/2008
- **Last updated:** 03/06/2008