Provider Demographics
NPI:1972003762
Name:KENNY, VANESSA A (CD(DONA))
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:A
Last Name:KENNY
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:A
Other - Last Name:KENNY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM
Mailing Address - Street 1:8 NEWBURY CT
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-5431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:123 FRANKLIN CORNER RD STE 214
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2526
Practice Address - Country:US
Practice Address - Phone:609-537-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-19
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR20829700163WM0102X, 163WX0003X
176B00000X, 374J00000X
NJ25ME00085201367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula