# KENNETT HMA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Twin Rivers Pediatrics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851618011
- **Authorized official:** LAURIE HOLTSFORD (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (615) 465-7466

## Contact information

- **Practice address:** 1312 1ST ST, KENNETT, MO 63857-2526
- **Practice address phone:** (573) 717-1080
- **Practice address fax:** (573) 717-1093
- **Mailing address:** 1312 1ST ST, KENNETT, MO 63857-2526
- **Mailing address phone:** (573) 717-1080
- **Mailing address fax:** (573) 717-1093

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 2009008960 | MO | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/28/2010
- **Last updated:** 07/23/2014