Provider Demographics
NPI:1477140184
Name:KENNEY, WINIFRED CHRISTINE
Entity Type:Individual
Prefix:
First Name:WINIFRED
Middle Name:CHRISTINE
Last Name:KENNEY
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 1:10134 PINEY MOUNTAIN RD SW
Mailing Address - Street 2:
Mailing Address - City:FROSTBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21532-3330
Mailing Address - Country:US
Mailing Address - Phone:304-813-2292
Mailing Address - Fax:
Practice Address - Street 1:10134 PINEY MOUNTAIN RD SW
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-3330
Practice Address - Country:US
Practice Address - Phone:304-813-2292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant