Individual
TRISHA LYNN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24276 166TH AIRPORT ROAD, EAGLE BUTTE, SD 57625
(605) 964-7724
Mailing address
PO BOX 1723, EAGLE BUTTE, SD 57625-1723
(605) 200-9111
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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