Provider Demographics
NPI:1598409740
Name:KENNEDY, BETHANY
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:KENNEDY
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 1:101 MORETTI CIR APT 305
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1968
Mailing Address - Country:US
Mailing Address - Phone:256-503-4343
Mailing Address - Fax:
Practice Address - Street 1:2200 CHILDREN'S WAY
Practice Address - Street 2:8232 DOCTORS' OFFICE TOWER
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-9225
Practice Address - Country:US
Practice Address - Phone:615-936-2555
Practice Address - Fax:615-936-3601
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program