Provider Demographics
NPI:1821528613
Name:KENNEY, SHARON E (RN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:E
Last Name:KENNEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 N BUSINESS DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5204
Mailing Address - Country:US
Mailing Address - Phone:866-523-8185
Mailing Address - Fax:479-582-0778
Practice Address - Street 1:2320 S LEMON ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-3755
Practice Address - Country:US
Practice Address - Phone:712-898-7067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA098437163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse