Individual
BETHANY JOY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226
(860) 456-9116
Mailing address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
(860) 456-9116
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
7663
CT
363LA2100X
Acute Care Nurse Practitioner
APRN01804
RI
Other
Enumeration date
07/01/2018
Last updated
07/26/2018
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