Kennelly, Kathryn Irene

Kennelly, Kathryn Irene is an individual health care provider with primary practice located at 617 E 16Th St , Plano TX 75074-5726. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kennelly, Kathryn Irene can be contacted via phone (972) 423-8110.

Contact Information

Primary practice address
617 E 16Th St Plano TX 75074-5726
Phone: (972) 423-8110
Fax: (972) 423-1699
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X F0804014 Texas

Profile Details

NPI number 1013971258
LBN Legal business name Kennelly, Kathryn Irene
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated Feb 26th, 2014 - about 12 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 1013971258 NPPES
Texas MEDICAID 169741902

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