Individual
MS. ANGELA KENNERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
17401 126TH AVE, JAMAICA, NY 11434-3313
(347) 970-9663
Mailing address
17401 126TH AVE, JAMAICA, NY 11434-3313
(347) 970-9663
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
210514
SC
163WA2000X
Administrator Registered Nurse
Primary
436416-1
NY
Other
Enumeration date
04/12/2025
Last updated
04/12/2025
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