Individual
STEPHANIE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2845 GREENBRIER RD, STE 330, GREEN BAY, WI 54308-8900
(920) 288-8350
(920) 288-8355
Mailing address
164 N BROADWAY, GREEN BAY, WI 54303-2728
(920) 965-4055
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
120176
WI
Other
Enumeration date
03/14/2014
Last updated
03/14/2014
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