MEDICARE: CHRISTOPHER KENNEDY

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
1	363LF0000X	Family Nurse Practitioner	CNP.020281	OH
2	363LF0000X	Family Nurse Practitioner	APRN11009113	FL
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	81063	NM
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11009113	FL
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	10032930	OR
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61615798	WA
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	229865	AK
8	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	C-APN.0103098-C-NP	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598209991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER KENNEDY

Provider Business Mailing Address
First Line	:	8885 GLASSFORD CT N
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-8337
Country	:	US
Telephone Number	:	407-693-2666
Fax Number	:

Provider Business Practice Location Address
First Line	:	4586 E MICHIGAN ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-5233
Country	:	US
Telephone Number	:	407-751-2297
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2016
Last Update Date	:	03/24/2025

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Directions to “ CHRISTOPHER KENNEDY ” Practice Location

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