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Individual

MRS. THERESA K KENNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
4330 ELMORE RD, ANCHORAGE, AK 99508-5907
(907) 729-6690
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024166263
VA
363LF0000X
Family Nurse Practitioner
Primary
162389
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1962523530
VA
Enumeration date
04/02/2007
Last updated
02/10/2026
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