Individual
KIMBERLY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
5252 N MERIDIAN AVE, OKLAHOMA CITY, OK 73112-2178
(405) 702-8623
Mailing address
5252 N MERIDIAN AVE, OKLAHOMA CITY, OK 73112-2178
(405) 702-8623
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95808
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200640890A
—
OK
Enumeration date
03/01/2016
Last updated
01/10/2022
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