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Individual

MS. MADELEINE O. KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
455 PHILIP BLVD STE 200, LAWRENCEVILLE, GA 30046-8766
(770) 363-6096
Mailing address
2003 ARBOR SPRINGS WAY, BUFORD, GA 30519-2286

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN173803
GA

Other

Enumeration date
11/06/2017
Last updated
11/06/2017
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