Healthcare Provider Details

I. General information

NPI: 1700350238
Provider Name (Legal Business Name): JAMES KENNY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2019
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 PLYMOUTH AVE STE 702
FALL RIVER MA
02721-4300
US

IV. Provider business mailing address

23 PLANTINGFIELD RD
MANSFIELD MA
02048-2040
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-4239
  • Fax:
Mailing address:
  • Phone: 774-284-0288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2261291
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: