Individual
JOHANNA LATRICE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 272-6000
(706) 272-6049
Mailing address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 272-6000
(706) 272-6049
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN260949
GA
Other
Enumeration date
10/26/2018
Last updated
05/01/2025
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