Individual
TARA ANN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP- BC
Contact information
Practice address
10810 MALLARD CREEK RD, CHARLOTTE, NC 28262-9786
(704) 510-8000
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5014370
NC
363LF0000X
Family Nurse Practitioner
5014370
NC
Other
Enumeration date
08/28/2007
Last updated
04/07/2026
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