Individual
MS. SARA ELLEN KENNEDY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RNC
Contact information
Practice address
2200 BERGQUIST DR, ATTN: CREDENTIALS (CMS), LACKLAND A F B, TX 78236-9908
(210) 292-6115
(210) 292-6158
Mailing address
11830 BRANDON OAKS, SAN ANTONIO, TX 78253-5816
(210) 678-0593
(210) 292-6158
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
566098
TX
Other
Enumeration date
05/01/2006
Last updated
07/08/2007
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