Individual
KARISA JO KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1215 NW 25TH ST, OKLAHOMA CITY, OK 73106-5629
(405) 525-2525
Mailing address
1516 SW 82ND CIR, OKLAHOMA CITY, OK 73159-5943
(405) 473-3307
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
09209205
OK
363LF0000X
Family Nurse Practitioner
Primary
202084
OK
Other
Enumeration date
07/09/2010
Last updated
04/25/2022
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