Individual
JOHN A KENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
19507
SC
363L00000X
Nurse Practitioner
NPP37581
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110084706A
—
MA
Enumeration date
01/15/2010
Last updated
01/11/2016
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