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MRS. JULIE ALLEN KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
2940 E BANNER GATEWAY DR, SUITE 200, GILBERT, AZ 85234-2168
(480) 964-2908
(480) 833-2136
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2765
AZ
363AS0400X
Surgical Physician Assistant
2765
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3Z3970
HEALTHNET
AZ
05
774811
AZ
Enumeration date
01/30/2006
Last updated
10/18/2022
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