Individual
KIRSTEN RENEE KENNEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
901 HEMPHILL, FORT WORTH, TX 76104
(817) 332-4060
(817) 332-2304
Mailing address
7749 NORTHUMBERLAND DR, FORT WORTH, TX 76179-2171
(214) 850-4958
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
80126
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200463201
—
TX
01
—
P00693131
RAILROAD MEDICARE
—
Enumeration date
06/03/2008
Last updated
01/31/2022
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