Individual
MRS. COLLEEN PISANO KENNERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
606 E 12TH ST, WASHINGTON, NC 27889-3409
(252) 974-9460
Mailing address
107 HARDING DR, WASHINGTON, NC 27889-9644
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
5016399
NC
Other
Enumeration date
08/03/2022
Last updated
02/19/2024
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