Individual
MRS. BROOKE ASHTON KENNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP APRN AG-ACNP-BC
Contact information
Practice address
6025 WALNUT GROVE RD STE 301, MEMPHIS, TN 38120-2123
(901) 226-0456
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5827
(901) 226-3186
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26355
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972144608
—
TN
Enumeration date
10/03/2019
Last updated
10/03/2024
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