Individual
MARILYN JULIETTE KENEBREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP109992
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153874604
—
TX
01
—
855N76
BCBS
TX
Enumeration date
11/02/2006
Last updated
09/11/2019
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