Individual
KAREN MARSHELIA KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1246 MADISON SE, GRAND RAPIDS, MI 49507
(616) 685-8300
(616) 685-8322
Mailing address
245 STATE ST SE, STE 221, GRAND RAPIDS, MI 49503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
224994
NY
207Q00000X
Family Medicine Physician
Primary
4301091353
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02320634
—
NY
01
—
114348
BOARD CERTIFICATE #
—
Enumeration date
07/18/2006
Last updated
09/12/2012
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