Individual
MS. JAMIE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5510 ALMA LN, SPRINGFIELD, VA 22151-4027
(703) 642-5990
Mailing address
15213 MUDDY CREEK CT, WOODBRIDGE, VA 22193-5882
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-009090
VA
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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