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Individual

DR. AMANDA DAWN KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, PMHNP

Contact information

Practice address
4364 WESTERN CENTER BLVD # 2221, FORT WORTH, TX 76137-2043
(817) 393-2061
(817) 393-2590
Mailing address
4364 WESTERN CENTER BLVD # 2221, FORT WORTH, TX 76137-2043
(817) 393-2061
(817) 393-2590

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
946888
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1095930
TX

Other

Enumeration date
10/05/2022
Last updated
10/05/2022
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