Individual
EMMALEE N KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1215 N BEAVER ST, FLAGSTAFF, AZ 86001-3126
(928) 773-2200
(928) 773-2300
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
33977
AZ
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
33977
AZ
208M00000X
Hospitalist Physician
33977
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186958
—
AZ
Enumeration date
02/10/2006
Last updated
04/16/2021
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