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Individual

KENYON MCCUNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
2633 CENTENNIAL BLVD, SUITE 100, TALLAHASSEE, FL 32308
(850) 431-5404
(850) 431-4794
Mailing address
2633 CENTENNIAL BLVD, STE 100, TALLAHASSEE, FL 32308-0606
(850) 431-5404
(850) 431-4794

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP2117432
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
307209600
FL
01
Y078N
BC/BS
FL
Enumeration date
12/06/2005
Last updated
04/28/2017
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