Individual
TAMARA KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-6020
Mailing address
12107 WEDGEWAY PL, FAIRFAX, VA 22033-2521
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
Primary
0001259238
VA
Other
Enumeration date
03/19/2020
Last updated
03/19/2020
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