Individual
MS. JACQUELINE F KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
181 STATE RD, WHATELY, MA 01093
(413) 665-0176
(413) 665-0176
Mailing address
P.O. BOX 205, WHATELY, MA 01093
(413) 665-0176
(413) 397-9760
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
169562
MA
363LP2300X
Primary Care Nurse Practitioner
169562
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0380890
—
MA
05
—
9709444
—
MA
Enumeration date
08/02/2005
Last updated
09/11/2025
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