Individual
DR. KELLY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3745 11TH CIR STE 101, VERO BEACH, FL 32960-4838
(772) 567-6412
(321) 567-4991
Mailing address
3745 11TH CIR STE 101, VERO BEACH, FL 32960-4838
(772) 567-6412
(321) 567-4991
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME160223
FL
207VX0000X
Obstetrics Physician
65523
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100058166
—
WI
Enumeration date
03/29/2012
Last updated
03/31/2025
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