Individual
MS. PATRICE KENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
12547 CERROMAR PL, FAIRFAX, VA 22030-6653
(757) 822-3949
Mailing address
38 FABYAN PL APT 3, NEWARK, NJ 07108-1086
(757) 822-3949
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
813779
NY
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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