Provider Demographics
NPI:1992845465
Name:KENNY, AMY G (APRN,BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:G
Last Name:KENNY
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 GASS RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15229-1012
Mailing Address - Country:US
Mailing Address - Phone:412-367-2227
Mailing Address - Fax:
Practice Address - Street 1:4416 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1312
Practice Address - Country:US
Practice Address - Phone:412-681-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2006010896363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA673053OtherBLUE CROSS BLUE SHIELD PA
PA631569OtherHIGHMARK
PA115421Medicare PIN
PA631569OtherHIGHMARK