Individual
MR. JAMES S KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3400 WAKE FOREST RD, RALEIGH, NC 27609-7317
(919) 954-3765
Mailing address
3100 SPRING FOREST RD, SUITE 130, RALEIGH, NC 27616-2880
(919) 873-9533
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
072171
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014MR
BCBS GROUP BILLING #
NC
01
—
560755775
COMMERCIAL
NC
05
—
8000311
—
NC
05
—
8052138
—
NC
Enumeration date
07/07/2006
Last updated
03/19/2015
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