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Individual
MRS. HEATHER MICHELLE KENNEDY
Active
Individual
MRS. HEATHER MICHELLE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50001264
OH
363A00000X
Physician Assistant
Primary
55607
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970028718
RAILROAD MEDICARE
KY
01
—
970028719
RAILROAD MEDICARE
OH
Enumeration date
07/13/2006
Last updated
05/01/2019
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