Individual
RACHEL N KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1700 I ST, LA PORTE, IN 46350-5750
(219) 362-6234
Mailing address
41800 W 11 MILE RD STE 109, NOVI, MI 48375-1818
(248) 660-1220
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP9337519
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300028727
—
IN
01
—
710008813A
INDIANA STATE LICENSE
IN
Enumeration date
11/11/2016
Last updated
09/25/2024
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