Individual
KENNEDI NULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
165 BURDETTE WAY, WHITE SULPHER SPRINGS, WV 24986
(304) 731-1168
Mailing address
PO BOX 585, WHITE SULPHUR SPRINGS, WV 24986-0585
(304) 731-1168
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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