Individual
JESSICA KENNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
269798
MA
363L00000X
Nurse Practitioner
269798
MA
363LP0200X
Pediatric Nurse Practitioner
269798
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN269798
MA
Other
Enumeration date
05/01/2015
Last updated
05/15/2026
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