Individual
MRS. JENNIFER JEAN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, ACNPG-NP, BSN,
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2894
(401) 793-2500
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN02852
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN02852
RI NP LICENSE
RI
Enumeration date
11/24/2021
Last updated
11/24/2021
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