Provider Demographics
NPI:1477960144
Name:KENNEDY, PATRICIA ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6249 INGHAM RD
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-9669
Mailing Address - Country:US
Mailing Address - Phone:215-750-7771
Mailing Address - Fax:215-750-6935
Practice Address - Street 1:1203 LANGHORNE NEWTOWN RD
Practice Address - Street 2:#225
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1209
Practice Address - Country:US
Practice Address - Phone:215-750-7771
Practice Address - Fax:215-750-6935
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily