Individual
KERRY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
328 COMERFORD TER, RIDLEY PARK, PA 19078-1822
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN264395
PA
Other
Enumeration date
12/14/2007
Last updated
12/14/2007
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