Individual
MAEGEN RICKI KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4107 SOUTH CAPTIAL TEXAS HWY SUITE 100A, AUSTIN, TX 78704
(512) 443-9355
Mailing address
300 WEST AVE APT 1327, AUSTIN, TX 78701
(239) 898-0054
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA07534
TX
Other
Enumeration date
12/28/2011
Last updated
12/28/2011
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