Organization
RED MAPLE PEDIATRICS LLC
Active
Organization
RED MAPLE PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE KENNEDY-FOSTER MD (MD)
(270) 438-6622
Entity
Organization
Contact information
Practice address
1621 NASHVILLE ST STE 106, RUSSELLVILLE, KY 42276-8871
(270) 946-1372
(270) 216-6185
Mailing address
1621 NASHVILLE ST STE 106, RUSSELLVILLE, KY 42276-8871
(270) 946-1372
(270) 216-6185
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/25/2022
Last updated
02/26/2024
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