Kennedy, Tara

Kennedy, Tara is an individual health care provider with primary practice located at 10826 Mallard Creek Rd Ste 100 , Charlotte NC 28262-7785. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Kennedy, Tara can be contacted via phone (704) 774-3044.

Contact Information

Primary practice address
10826 Mallard Creek Rd Ste 100 Charlotte NC 28262-7785
Phone: (704) 774-3044
Fax: (704) 774-3045
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 5334 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 122656 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 5014370 North Carolina

Profile Details

NPI number 1245424761
LBN Legal business name Kennedy, Tara
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2007
Last updated Sep 13th, 2021 - about 5 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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