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Individual

MRS. GEENA ROSE KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3007 WESLEY CHAPEL STOUTS RD, MONROE, NC 28110-4007
(704) 412-3612
(704) 412-3614
Mailing address
3007 WESLEY CHAPEL STOUTS RD, MONROE, NC 28110-4007
(919) 454-9356

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001011977
NC

Other

Enumeration date
03/10/2021
Last updated
03/12/2024
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