Individual
MARY KATHRYN KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1845 S FM 51 UNIT A-2, DECATUR, TX 76234-3764
(940) 727-3033
Mailing address
1308 RODDEN DR, DECATUR, TX 76234-3620
(940) 627-7772
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
234256
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88938803
—
TX
Enumeration date
08/22/2006
Last updated
10/29/2007
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