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Individual

DR. KATHERINE EDITHE KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
1728 W GLENDALE AVE STE 100, PHOENIX, AZ 85021-8862
(480) 812-3668
(480) 782-1290
Mailing address
1728 W GLENDALE AVE STE 100, PHOENIX, AZ 85021-8862
(480) 812-3668
(480) 782-1290

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0818
AZ
213ES0103X
Foot & Ankle Surgery Podiatrist
135.000790
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Z179475
AZ
Enumeration date
10/20/2012
Last updated
09/12/2019
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