Individual
PHYLLIS A KENNEDY-HOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2700 N OAK ST, VALDOSTA, GA 31602-1772
(229) 249-8687
(229) 249-9282
Mailing address
660 GORNTO CEMETERY RD, BARNEY, GA 31625-3248
(229) 456-2152
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
189066
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN189066
GA
Other
Enumeration date
02/17/2017
Last updated
03/18/2019
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