Individual
JESSICA RENE' KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7125 S BRADEN AVE, TULSA, OK 74136-6302
(918) 481-8100
Mailing address
9534 W COUNTRY RD, SAND SPRINGS, OK 74063-7828
(405) 880-5944
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
87596
OK
Other
Enumeration date
04/05/2019
Last updated
11/27/2019
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