Individual
LADAWN DENISE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
16645 ILENE ST, DETROIT, MI 48221-3401
(313) 477-3661
Mailing address
16645 ILENE ST, DETROIT, MI 48221-3401
(313) 477-3661
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704219940
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704219940
MI
Other
Enumeration date
08/13/2019
Last updated
11/12/2020
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