Individual
MICHELLE M KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNC WHNP
Contact information
Practice address
222 TONGASS DR, 514 LAKE STREET SUITE B, SITKA, AK 99835-9416
(907) 966-8772
(907) 966-8708
Mailing address
109 BAHRT CIR, SITKA, AK 99835-7237
(907) 966-8772
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
946
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104094424
—
AK
Enumeration date
02/20/2008
Last updated
06/22/2009
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