Healthcare Provider Details

I. General information

NPI: 1780597211
Provider Name (Legal Business Name): RACHEL KENNEDY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2637 TUSKY VALLEY RD NE
ZOARVILLE OH
44656-9692
US

IV. Provider business mailing address

2637 TUSKY VALLEY RD NE
ZOARVILLE OH
44656-9692
US

V. Phone/Fax

Practice location:
  • Phone: 330-859-2213
  • Fax:
Mailing address:
  • Phone: 330-859-2213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.347726
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: