Individual
ELIZABETH ANN KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4996
(662) 377-3000
Mailing address
PO BOX 3294, TUPELO, MS 38803-3294
(662) 377-4394
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
901871
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/31/2023
Last updated
10/04/2023
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