Individual
JENNIFER MICHALEC KENNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11840 SOUTHMORE DR, SUITE 200, CHARLOTTE, NC 28277-4466
(704) 384-1166
(704) 384-1181
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1166
(704) 384-1181
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2011-00073
NC
2080N0001X
Neonatal-Perinatal Medicine Physician
2011-00073
NC
2080N0001X
Neonatal-Perinatal Medicine Physician
28920
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
289208
—
SC
05
—
5918767
—
NC
Enumeration date
10/16/2006
Last updated
10/25/2020
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