Individual
JEFFREY LYNN KENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
105 LAMPASAS WAY, WAKE VILLAGE, TX 75501-5791
(903) 293-1142
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
790105
TX
Other
Enumeration date
07/21/2023
Last updated
07/21/2023
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