Individual
ANNE MARIA KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBCH
Contact information
Practice address
50 N MEDICAL DR, 1A71, SALT LAKE CITY, UT 84132-0001
(801) 581-7553
Mailing address
PO BOX 581200, SALT LAKE CITY, UT 84158-1200
(801) 213-3900
(801) 585-3655
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
188021-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300025638
RAILROAD MEDICARE
UT
Enumeration date
10/09/2006
Last updated
11/03/2021
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