Individual
KENNEDY PRATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1722 SHAFFER ST, KALAMAZOO, MI 49048-1633
(269) 381-3963
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601013581
MI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427848407
—
MI
Enumeration date
05/12/2025
Last updated
04/08/2026
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