Provider Demographics
NPI:1942060140
Name:ELIZABETH KENNETT RN
Entity Type:Organization
Organization Name:ELIZABETH KENNETT RN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-458-3759
Mailing Address - Street 1:47 DRESDEN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:ME
Mailing Address - Zip Code:04345-2612
Mailing Address - Country:US
Mailing Address - Phone:207-458-3759
Mailing Address - Fax:
Practice Address - Street 1:47 DRESDEN AVE
Practice Address - Street 2:
Practice Address - City:GARDINER
Practice Address - State:ME
Practice Address - Zip Code:04345-2612
Practice Address - Country:US
Practice Address - Phone:207-458-3759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care