Individual
ELIZABETH KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
767 BLANDING BLVD STE 110B, ORANGE PARK, FL 32065-5788
(803) 318-2052
Mailing address
767 BLANDING BLVD STE 110B, ORANGE PARK, FL 32065-5788
(803) 318-2052
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
FL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/02/2022
Last updated
03/02/2022
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