DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: KENNEDY EVANS

MEDICARE: KENNEDY EVANS
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
1106S00000XBehavior TechnicianNC

General Provider Information

NPI Number : 1609710490
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNEDY EVANS
Provider Business Mailing Address
First Line : 2857 OASIS LN
Second Line :
City : CHARLOTTE
State : NC
Zip : 28214-8866
Country : US
Telephone Number : 704-763-7269
Fax Number :
Provider Business Practice Location Address
First Line : 2101 CAMBRIDGE BELTWAY DR STE E
Second Line :
City : CHARLOTTE
State : NC
Zip : 28273-4351
Country : US
Telephone Number : 615-560-6622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

Similar Medicare Providers

1811831324 — HANNAH NOEL FREDERICK
Practice Location Address:
2101 CAMBRIDGE BELTWAY DR STE E
CHARLOTTE, NC
28273-4351
Practice Phone: 704-799-6824
Practice Fax:
1194667592 — KEAIRA ALEXIA CURRY
Practice Location Address:
2101 CAMBRIDGE BELTWAY DR STE E
CHARLOTTE, NC
28273-4351
Practice Phone: 704-799-6824
Practice Fax:
1376485391 — SEMIRA TAMRAT
Practice Location Address:
2101 CAMBRIDGE BELTWAY DR STE E
CHARLOTTE, NC
28273-4351
Practice Phone: 615-560-6622
Practice Fax:
1285576173 — EVA PETRULIS
Practice Location Address:
2101 CAMBRIDGE BELTWAY DR STE E
CHARLOTTE, NC
28273-4351
Practice Phone: 704-799-6824
Practice Fax:
1598608242 — JENNIFER CELESTE MA
Practice Location Address:
2101 CAMBRIDGE BELTWAY DR STE E
CHARLOTTE, NC
28273-4351
Practice Phone: 615-560-6622
Practice Fax:
1922847789 — KHIA TRUESDALE
Practice Location Address:
2101 CAMBRIDGE BELTWAY DR STE E
CHARLOTTE, NC
28273-4351
Practice Phone: 704-799-6824
Practice Fax:

Directions to “ KENNEDY EVANS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.