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Individual

MISS AMANDA RENEE KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
9500 EUCLID AVE # R3, CLEVELAND, OH 44195-3678
(216) 442-4418
Mailing address
262 DANNY THOMAS PL # MS 515, MEMPHIS, TN 38105-3678

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
17748
OH
363LP0200X
Pediatric Nurse Practitioner
23173
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0152679
OH
01
COA.17748-NP
COA FOR STATE OF OHIO BOARD OF NURSING
OH
Enumeration date
07/21/2015
Last updated
01/07/2022
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