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Individual

STEPHANIE ANN KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CNP

Contact information

Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2250
Mailing address
PO BOX 638685, CINCINNATI, OH 45263-8685
(859) 572-3617
(833) 643-8146

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3017110
KY
363L00000X
Nurse Practitioner
71012111A
IN
363LF0000X
Family Nurse Practitioner
0029132
OH

Other

Enumeration date
06/24/2021
Last updated
04/03/2025
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