Individual
CAROLYN LANEY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2475 GARRISON AVE, PORT ST JOE, FL 32456-5265
(850) 229-9710
(850) 227-1794
Mailing address
2017 MARVIN AVE, PORT ST JOE, FL 32456-2050
(850) 227-3340
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN 9200370
FL
Other
Enumeration date
03/09/2006
Last updated
07/08/2007
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