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Individual

MR. JAMES R KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1104 TUSCULUM BLVD, SUITE 114, GREENEVILLE, TN 37745-4091
(423) 639-0941
Mailing address
:PO BOX, PO BOX 896138, CHARLOTTE, NC 28289-6138
(833) 500-9914

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
8772
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3049637
BC/BS
TN
05
3600923
TN
Enumeration date
04/10/2006
Last updated
09/22/2022
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