Kennedy, Nicole Lynette

Kennedy, Nicole Lynette is an individual health care provider with primary practice located at 3411 Professional Park Drive Simca, Marion IL 62959. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Kennedy, Nicole Lynette can be contacted via phone (618) 997-2161.

Contact Information

Primary practice address
3411 Professional Park Drive Simca Marion IL 62959
Phone: (618) 997-2161
Fax: (618) 997-2464
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 32561 South Carolina
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 036132187 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036132187 Illinois

Profile Details

NPI number 1780902486
LBN Legal business name Kennedy, Nicole Lynette
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2010
Last updated Aug 21st, 2023 - about 3 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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