Organization
LYNNETTE D HANSEN KENNISON PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNETTE HANSEN KENNISON PH D ARPN (OWNER)
(904) 296-3113
Entity
Organization
Contact information
Practice address
6817 SOUTHPOINT PKWY STE 304, JACKSONVILLE, FL 32216-6287
(904) 296-3113
(904) 296-3144
Mailing address
12484 MASTERS RIDGE DR, JACKSONVILLE, FL 32225-5758
(904) 982-7060
(904) 269-3144
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP1117892
FL
Other
Enumeration date
03/06/2008
Last updated
03/06/2008
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