Individual
KENNEDY TAMBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
64 MAIN ST APT 35B, STONEHAM, MA 02180-3384
(617) 286-3364
Mailing address
64 MAIN ST APT 35B, STONEHAM, MA 02180-3384
(617) 286-3364
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN237828
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020860
—
MA
Enumeration date
10/16/2020
Last updated
11/14/2024
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