Provider Demographics
NPI:1437361094
Name:KENNEDY, KATE A (ND)
Entity Type:Individual
Prefix:DR
First Name:KATE
Middle Name:A
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 12TH AVE S
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4600
Mailing Address - Country:US
Mailing Address - Phone:406-727-6680
Mailing Address - Fax:406-727-4777
Practice Address - Street 1:1301 12TH AVE S
Practice Address - Street 2:SUITE 203
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4600
Practice Address - Country:US
Practice Address - Phone:406-727-6680
Practice Address - Fax:406-727-4777
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT106175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath