Organization
SOUTH COUNTY WELLNESS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY L KENNEDY PCNS (PRESCRIPTIVE CLINICAL NURSE SPECIAL)
(401) 667-7079
Entity
Organization
Contact information
Practice address
1130 TEN ROD RD, SUITE E302, NORTH KINGSTOWN, RI 02852-4161
(401) 667-7079
Mailing address
1130 TEN ROD RD, SUITE E302, NORTH KINGSTOWN, RI 02852-4161
(401) 667-7079
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
PPNS00010
RI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
PPNS00047
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043260268
NPI
RI
01
—
1962597336
NPI
RI
Enumeration date
12/19/2006
Last updated
08/22/2020
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