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Individual

DANIEL BERNARD KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DHAT

Contact information

Practice address
7300 KLAWOCK HOLLIS HIGHWAY, KLAWOCK, AK 99925
(907) 755-4990
(907) 755-4811
Mailing address
PO BOX 69, KLAWOCK, AK 99925-0069
(907) 755-4990
(907) 755-4811

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06-031-DHAT
COMMUNITY HEALTH AIDE CERTIFICATION BOARD - FEDERAL CERTIFICATION
AK
Enumeration date
04/23/2012
Last updated
04/23/2012
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