Individual
KATHLEEN MARY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
229-231 STATE ST, BROOME COUNTY MENTAL HEALTH, BINGHAMTON, NY 13901-2756
(607) 778-1122
(607) 778-1164
Mailing address
48 EDSON RD, ENDICOTT, NY 13760-6435
(607) 765-7075
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
F320027
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401064
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0320F320027
—
NY
Enumeration date
06/13/2006
Last updated
07/14/2010
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