Individual
MRS. LISA KENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNPC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN17474
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
373810
BCBS
MT
05
—
4302343
—
MT
01
—
P00121261
RAILROAD MEDICARE
MT
Enumeration date
01/11/2006
Last updated
07/21/2022
Update your record
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