Individual
LATOSHA M KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CRNA
Contact information
Practice address
1 KISH HOSPITAL DR, DEKALB, IL 60115-9602
(815) 756-1521
(815) 766-9647
Mailing address
1 KISH HOSPITAL DR, DEKALB, IL 60115-9602
(815) 756-1521
(815) 766-9647
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2022009227
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209028521
IL
367500000X
Certified Registered Nurse Anesthetist
RN093957
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1721581
—
LA
01
—
20-1249716
FEDERAL TAX I.D.NUMBER
LA
Enumeration date
11/06/2006
Last updated
02/05/2026
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