Kennedy, Colleen Marie

Kennedy, Colleen Marie is an individual health care provider with primary practice located at 425 Centre View Blvd , Crestview Hills KY 41017-3409. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Kennedy, Colleen Marie can be contacted via phone (859) 341-3575.

Contact Information

Primary practice address
425 Centre View Blvd Crestview Hills KY 41017-3409
Phone: (859) 341-3575
Fax: (859) 341-5702
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9101536 Florida
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA1114 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1114 Kentucky

Profile Details

NPI number 1154302388
LBN Legal business name Kennedy, Colleen Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 5th, 2005
Last updated Feb 16th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154302388 NPPES
Kentucky MEDICAID 7100320670
Kentucky MEDICAID 291895100

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