Individual
JOANNA RUTH KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
602 E FORT UNION BLVD, MIDVALE, UT 84047-2216
(801) 313-1010
Mailing address
602 E FORT UNION BLVD, MIDVALE, UT 84047-2216
(801) 313-1010
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
73008658900
UT
Other
Enumeration date
02/12/2017
Last updated
02/12/2017
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