Healthcare Provider Details

I. General information

NPI: 1972003762
Provider Name (Legal Business Name): VANESSA A KENNY CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VANESSA A KENNY CNM

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 FRANKLIN CORNER RD STE 214
LAWRENCEVILLE NJ
08648-2526
US

IV. Provider business mailing address

8 NEWBURY CT
JACKSON NJ
08527-5431
US

V. Phone/Fax

Practice location:
  • Phone: 609-537-7200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number26NR20829700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number26NR20829700
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number25ME00085201
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: