Provider Demographics
NPI:1831491034
Name:KENNEDY, JEANETTE ELEANOR (RN, MS, CNS)
Entity Type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:ELEANOR
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:RN, MS, CNS
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Mailing Address - Street 1:700 WELCH RD
Mailing Address - Street 2:PEDS RHEUM SUITE 301
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1502
Mailing Address - Country:US
Mailing Address - Phone:650-723-8295
Mailing Address - Fax:
Practice Address - Street 1:730 WELCH RD
Practice Address - Street 2:PEDIARIC RHEUMATOLOGY
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1503
Practice Address - Country:US
Practice Address - Phone:650-723-8295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA1040364SC2300X, 364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
No364SC2300XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistChronic Care