Individual
ANDREA M KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 MEDICAL WAY, SNELLVILLE, GA 30078-2195
(770) 979-0200
Mailing address
2311 RIDGE FOREST DR, GRAYSON, GA 30017-1718
(678) 656-6819
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
GA
363AS0400X
Surgical Physician Assistant
Primary
175866
GA
Other
Enumeration date
12/19/2017
Last updated
12/27/2021
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