Individual
STACY D. KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
611 MOCKSVILLE AVE., SALISBURY, NC 28144-2705
(704) 633-7220
(704) 647-0515
Mailing address
611 MOCKSVILLE AVE, SALISBURY, NC 28144-2705
(704) 633-7220
(704) 647-0515
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2009-00173
NC
207RR0500X
Rheumatology Physician
Primary
2009-00173
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5912324
—
NC
Enumeration date
02/18/2007
Last updated
03/18/2020
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