Kennedy, Michelle L

Kennedy, Michelle L is an individual health care provider with primary practice located at 6140 W Curtisian Ave Ste 200, Boise ID 83704. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Kennedy, Michelle L can be contacted via phone (208) 302-0000.

Contact Information

Primary practice address
6140 W Curtisian Ave Ste 200 Boise ID 83704
Phone: (208) 302-0000
Fax: (208) 302-0055
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X A004645 Arkansas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 57400 Idaho

Profile Details

NPI number 1982062857
LBN Legal business name Kennedy, Michelle L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2016
Last updated May 16th, 2018 - about 8 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 1982062857 NPPES
Arkansas Other A004645 STATE LICENSE

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