Individual
JOHANNAH ROSE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
29201 TELEGRAPH RD STE 500, SOUTHFIELD, MI 48034-7648
(248) 569-5985
Mailing address
29201 TELEGRAPH RD STE 500, SOUTHFIELD, MI 48034-7648
(248) 569-5985
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601013016
MI
Other
Enumeration date
02/21/2025
Last updated
02/21/2025
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