Individual
TISHA KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADN,RBT
Contact information
Practice address
800 N MAIN ST, ANNA, IL 62906-1665
(618) 833-4456
(618) 833-2371
Mailing address
902 W MAIN ST, WEST FRANKFORT, IL 62896-2210
(618) 937-6483
(618) 937-1440
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.547512
IL
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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