Individual
DIANE L KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1601 SIOUX VALLEY DRIVE, LUVERNE, MN 56156
(507) 283-4476
(507) 283-9086
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9556
(605) 328-9501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34864
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332090100
—
MN
Enumeration date
08/22/2005
Last updated
03/31/2022
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