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Individual

KRISTI A KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
1485 JESSE JEWELL PKWY NE, SUITE 200, GAINESVILLE, GA 30501-3806
(770) 534-5255
(770) 287-3871
Mailing address
1485 JESSE JEWELL PKWY NE, SUITE 200, GAINESVILLE, GA 30501-3806
(770) 534-5255
(770) 287-3871

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN122165
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000883077C
GA
05
00883077A
GA
Enumeration date
03/07/2007
Last updated
06/19/2012
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