Individual
DEEANNA EMMALYNN KENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
715 E MAIN ST STE 108, MIDLAND, MI 48640-5488
(989) 488-1150
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
(616) 486-6702
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005739
MI
Other
Enumeration date
05/12/2010
Last updated
05/13/2024
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