Provider Demographics
NPI:1063674026
Name:KENNEDY, MARY CAROL PATRICIA (MSN RN CS CCDP-D)
Entity Type:Individual
Prefix:MS
First Name:MARY CAROL
Middle Name:PATRICIA
Last Name:KENNEDY
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Gender:F
Credentials:MSN RN CS CCDP-D
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Mailing Address - Street 1:519 PENN AVE
Mailing Address - Street 2:TCV
Mailing Address - City:TURTLE CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:15145-2082
Mailing Address - Country:US
Mailing Address - Phone:412-824-8510
Mailing Address - Fax:412-824-0179
Practice Address - Street 1:723 BRADDOCK AVE
Practice Address - Street 2:TCV
Practice Address - City:BRADDOCK
Practice Address - State:PA
Practice Address - Zip Code:15104-1849
Practice Address - Country:US
Practice Address - Phone:412-824-8510
Practice Address - Fax:412-824-0179
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
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Provider Licenses
StateLicense IDTaxonomies
PARN158452L163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health