Provider Demographics
NPI:1891953451
Name:DAVIS-KENNEDY, KATINA (DNP, FNP-C, PMHNP)
Entity Type:Individual
Prefix:
First Name:KATINA
Middle Name:
Last Name:DAVIS-KENNEDY
Suffix:
Gender:F
Credentials:DNP, FNP-C, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 CORAL HILLS DR STE 330
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4165
Mailing Address - Country:US
Mailing Address - Phone:954-231-8700
Mailing Address - Fax:954-231-8707
Practice Address - Street 1:2901 CORAL HILLS DR STE 330
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4165
Practice Address - Country:US
Practice Address - Phone:954-231-8700
Practice Address - Fax:954-231-8707
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9204487363LP0808X
FLARNP9204487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health