Individual
BLAKE AUSTIN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1211 S GLOSTER ST STE A, TUPELO, MS 38801-6548
(662) 767-4200
Mailing address
1211 S GLOSTER ST STE A, TUPELO, MS 38801-6548
(662) 767-4200
(662) 767-4201
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904722
MS
Other
Enumeration date
11/18/2021
Last updated
08/28/2025
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