Individual
CHRIS ROBERT KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5440 CARIBOU RIDGE DR, WATAUGA, TX 76137-4730
(817) 437-3865
Mailing address
5440 CARIBOU RIDGE DR, WATAUGA, TX 76137-4730
(817) 437-3865
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
195989
TX
Other
Enumeration date
04/06/2018
Last updated
04/06/2018
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