Provider Demographics
NPI:1790054914
Name:KENNADY, BERNARD
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:
Last Name:KENNADY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 N ORACLE RD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7732
Mailing Address - Country:US
Mailing Address - Phone:520-745-5222
Mailing Address - Fax:520-745-9030
Practice Address - Street 1:6700 N ORACLE RD
Practice Address - Street 2:SUITE 118
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7732
Practice Address - Country:US
Practice Address - Phone:520-745-5222
Practice Address - Fax:520-745-9030
Is Sole Proprietor?:No
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide