Individual
RACHEL MILES KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7858 SHRADER RD, RICHMOND, VA 23294-4222
(804) 270-1305
Mailing address
PO BOX 715868 PHILADELPHIA, PHILADELPHIA, PA 19171-5868
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T66840789
DRIVERS LICENSE
VA
Enumeration date
02/21/2019
Last updated
04/06/2022
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