Provider Demographics
NPI:1740886035
Name:KENNEDY, ANDRIENA
Entity type:Individual
Prefix:
First Name:ANDRIENA
Middle Name:
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 FORREST ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3344
Mailing Address - Country:US
Mailing Address - Phone:336-549-8301
Mailing Address - Fax:
Practice Address - Street 1:2006 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27260-5729
Practice Address - Country:US
Practice Address - Phone:336-549-8301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health