Provider Demographics
NPI:1043101777
Name:PARHAM, KENNEDY (WHNP)
Entity type:Individual
Prefix:
First Name:KENNEDY
Middle Name:
Last Name:PARHAM
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14605-2992
Mailing Address - Country:US
Mailing Address - Phone:315-496-3824
Mailing Address - Fax:585-546-5639
Practice Address - Street 1:1120 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1994
Practice Address - Country:US
Practice Address - Phone:866-600-6886
Practice Address - Fax:315-475-5554
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY986991163W00000X
NY421876363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse