Provider Demographics
NPI:1275032765
Name:MOREY, KENNEDY JANAE
Entity Type:Individual
Prefix:
First Name:KENNEDY
Middle Name:JANAE
Last Name:MOREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13163 238TH ST
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66052-4204
Mailing Address - Country:US
Mailing Address - Phone:785-917-0706
Mailing Address - Fax:
Practice Address - Street 1:13163 238TH ST
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:KS
Practice Address - Zip Code:66052-4204
Practice Address - Country:US
Practice Address - Phone:785-917-0706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer