Individual
MS. BETH A. KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
930 N SWITZER CANYON DR, SUITE 202, FLAGSTAFF, AZ 86001-4824
(928) 779-5707
(928) 779-5753
Mailing address
930 N SWITZER CANYON DR, SUITE 202, FLAGSTAFF, AZ 86001-4824
(928) 779-5707
(928) 779-5753
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP1689
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202101
—
AZ
01
—
AP1689
NP LICENSE #
AZ
01
—
RN121857
RN LICENSE #
AZ
Enumeration date
11/15/2006
Last updated
02/07/2014
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