Provider Demographics
NPI:1407465651
Name:ONORI, KENNEDY U (PHD, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:KENNEDY
Middle Name:U
Last Name:ONORI
Suffix:
Gender:M
Credentials:PHD, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 HIGHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596-7914
Mailing Address - Country:US
Mailing Address - Phone:919-720-0480
Mailing Address - Fax:
Practice Address - Street 1:315 FRANKLIN PLZ
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2765
Practice Address - Country:US
Practice Address - Phone:919-496-4976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013352363LF0000X, 363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care