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Individual

JOSIE L KENNICUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
625 W WILLIAM AVE, NORTH PLATTE, NE 69101-0026
(308) 289-3574
Mailing address
810 COBBLER LN, SUTHERLAND, NE 69165-7278
(308) 289-3574

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
07/14/2022
Last updated
01/12/2024
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