Individual
NATHANIEL GEORGE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3101 BARDSTOWN ROAD, SULLIVAN UNIVERSITY PHYSICIAN ASSISTANT PROGRAM, LOUISVILLE, KY 40205
(502) 413-8659
Mailing address
5316 GARDEN DR, CRESTWOOD, KY 40014-8843
(612) 787-8818
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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