Individual provider · NPI-1

Dr. Agnes Kenny, MD

General Practice · Peru, IN

NPI number1427013952
StatusActive
Last updated in NPPESAug 15, 2016

Details

NPI
1427013952
Entity type
Individual (NPI-1)
Name
Dr. Agnes Kenny
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Apr 18, 2006
Last updated
Aug 15, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General Practice01031072AINYes

Practice location

1694 W Logansport Rd
Peru, IN 46970-3149

Phone 765-472-2812 · Fax 765-472-2970

Mailing address

1694 W Logansport Rd
Peru, IN 46970-3149

Phone 765-472-2812 · Fax 765-472-2970

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