Andra R Kennedy, PA
Physician Assistant in Johnston, IA. Individual provider (NPI-1).
NPI number1083674097
StatusActive
Last updated in NPPESOct 16, 2007
Details
- NPI
- 1083674097
- Entity type
- Individual (NPI-1)
- Name
- Andra R Kennedy
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 24, 2006
- Last updated
- Oct 16, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 648 | IA | Yes |
Practice location
5900 Nw 86th StSuite 100
Johnston, IA 50131-2284
Phone 515-276-6133 · Fax 515-334-7356
Mailing address
5900 Nw 86th StSuite 100
Johnston, IA 50131-2284
Phone 515-276-6133 · Fax 515-334-7356
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physician Assistant providers in Johnston, IA
- Laurie Lavon Clair, MSPA, PA-CNPI 1790046548
- Elizabeth A Foutch, PANPI 1194519256
- Olivia Mae MiesnerNPI 1083592026
- Luke William Ryan, PA-CNPI 1255034120
- Alexis V Taylor, PANPI 1861788895
All 6 Physician Assistant providers in Johnston · All 771 providers in Johnston
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