Individual
MICHELLE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RSA
Contact information
Practice address
1301 S KOKE MILL RD, SPRINGFIELD, IL 62711-9252
(217) 547-9100
Mailing address
1301 S KOKE MILL RD, SPRINGFIELD, IL 62711-9252
(217) 547-9100
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
246ZS0410X
Surgical Technologist
—
—
Other
Enumeration date
02/05/2009
Last updated
04/25/2022
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