Individual
SHELLY K KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
141 S EMERSON AVE, WENATCHEE, WA 98801-2612
(504) 452-5252
Mailing address
141 S EMERSON AVE, WENATCHEE, WA 98801-2612
(504) 452-5252
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN126476
LA
363LF0000X
Family Nurse Practitioner
AP08549
LA
363LF0000X
Family Nurse Practitioner
Primary
AP60686679
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04274756
—
MS
05
—
2078508
—
WA
Enumeration date
09/28/2015
Last updated
10/23/2024
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