Stacy Kennedy, OD
Optometrist in Harvey, LA. Individual provider (NPI-1).
NPI number1720149016
StatusActive
Last updated in NPPESJul 9, 2007
Details
- NPI
- 1720149016
- Entity type
- Individual (NPI-1)
- Name
- Stacy Kennedy
- Credential
- OD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 12, 2006
- Last updated
- Jul 9, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 715 | LA | Yes |
Practice location
1801 Manhattan BlvdU
Harvey, LA 70058-7300
Phone 504-367-3930
Mailing address
11103 West AveSte 6
San Antonio, TX 78213-1370
Phone 210-524-6803 · Fax 210-524-6587
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