Individual
KATHRYN R. HENNESSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
119 SHOEMAKER RD, POTTSTOWN, PA 19464-6429
(610) 427-4919
(610) 489-6418
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS007723L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013910420002
—
PA
01
—
0279841000
IBC - PC/KHPE
PA
01
—
1089445
CIGNA HMO/PPO
PA
01
—
10928555
CAQH ID#
PA
01
—
16452-OS007723L
HEALTH PARTNERS
PA
01
—
195050
HIGHMARK BLUE SHIELD
PA
01
—
30019705
KEYSTONE MERCY
PA
01
—
4358937
AETNA PPO
PA
01
—
P00186614
RRM
PA
Enumeration date
06/19/2006
Last updated
02/09/2022
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