Provider Demographics
NPI:1962638445
Name:KENNEDY, ERIN E (CNP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:E
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:E
Other - Last Name:SILVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:4777 E GALBRAITH RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2725
Mailing Address - Country:US
Mailing Address - Phone:513-829-1700
Mailing Address - Fax:513-829-5333
Practice Address - Street 1:4777 E GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2725
Practice Address - Country:US
Practice Address - Phone:513-829-1700
Practice Address - Fax:513-829-5333
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.319860-COA1163W00000X
OHAPRN.CNP.10755363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0072370Medicaid