Bethany Joy Kennedy, APRN
Nurse Practitioner, Acute Care in Willimantic, CT. Individual provider (NPI-1).
NPI number1003301136
StatusActive
Last updated in NPPESJul 26, 2018
Details
- NPI
- 1003301136
- Entity type
- Individual (NPI-1)
- Name
- Bethany Joy Kennedy
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 1, 2018
- Last updated
- Jul 26, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2100X | Nurse Practitioner, Acute Care | 7663 | CT | Yes |
| 363LA2100X | Nurse Practitioner, Acute Care | APRN01804 | RI |
Practice location
112 Mansfield AveWillimantic, CT 06226
Phone 860-456-9116
Mailing address
112 Mansfield AveWillimantic, CT 06226-2045
Phone 860-456-9116
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