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NPI Code Detail

MEDICARE: TARA ANN KENNEDY FNP- BC

MEDICARE:   TARA ANN KENNEDY  FNP- BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner5014370NC
2363LF0000XFamily Nurse Practitioner5014370NC

General Provider Information

NPI Number : 1245424761
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA ANN KENNEDY FNP- BC
Provider Business Mailing Address
First Line : 14230 HUNTERS RD
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-7335
Country : US
Telephone Number : 704-316-6611
Fax Number : 704-316-6612
Provider Business Practice Location Address
First Line : 14230 HUNTERS RD
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-7335
Country : US
Telephone Number : 704-316-6611
Fax Number : 704-316-6612
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2007
Last Update Date : 01/29/2026

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Directions to “ TARA ANN KENNEDY FNP- BC” Practice Location

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