Individual
JANILE SUSAN KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED NURSE
Contact information
Practice address
108 YELLOW CREEK RD, EVANSTON, WY 82930-5234
(307) 789-2652
(307) 789-6227
Mailing address
108 YELLOW CREEK RD, EVANSTON, WY 82930-5234
(307) 789-2652
(307) 789-6227
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
4838
WY
261Q00000X
Clinic/Center
Primary
190032638 A
WY
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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