Individual
MRS. JESSICA KENNEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1002 NE HIGHWAY 66, STE 2, SAYRE, OK 73662-9305
(580) 928-2208
(580) 928-2246
Mailing address
1002 NE HIGHWAY 66, STE 2, SAYRE, OK 73662-9305
(580) 928-2208
(580) 928-2246
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
58430
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200261780A
—
OK
Enumeration date
08/27/2009
Last updated
10/25/2021
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