Kennedy, Tara

Kennedy, Tara is an individual health care provider with primary practice located at W180N8000 Town Hall Rd , Menomonee Falls WI 53051-4002. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Kennedy, Tara can be contacted via phone (262) 532-3700.

Contact Information

Primary practice address
W180N8000 Town Hall Rd Menomonee Falls WI 53051-4002
Phone: (262) 532-3700
Fax: (262) 532-3725
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 69210-20 Wisconsin

Profile Details

NPI number 1992191662
LBN Legal business name Kennedy, Tara
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2015
Last updated Jun 23rd, 2022 - about 4 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 1992191662 NPPES
Wisconsin MEDICAID 1992191662

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