Provider Demographics
NPI:1831589043
Name:JESSE, JANICE KENNEY (MD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:KENNEY
Last Name:JESSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:LOUISE
Other - Last Name:KENNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 WEXLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-7649
Mailing Address - Country:US
Mailing Address - Phone:804-741-6685
Mailing Address - Fax:
Practice Address - Street 1:207 WEXLEIGH DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-7649
Practice Address - Country:US
Practice Address - Phone:804-741-6685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050071207ZP0102X, 207ZB0001X
GA059250207ZP0102X, 207ZB0001X
NC200501949207ZP0102X, 207ZB0001X
MDD74937207ZP0102X, 207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine