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Individual

DEBRA KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
710 CENTER ST, COLUMBUS, GA 31901-1527
(706) 660-6229
(706) 660-6504
Mailing address
PO BOX 1038, COLUMBUS, GA 31902-1038
(706) 660-6410
(706) 660-2847

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
RN175892
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003146964B
GA
Enumeration date
05/22/2014
Last updated
08/25/2014
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