Healthcare Provider Details

I. General information

NPI: 1316913130
Provider Name (Legal Business Name): NANCY KENNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 12/05/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 HOSPITAL DR SUITE 2
EVERETT PA
15537-7022
US

IV. Provider business mailing address

311 HOSPITAL DR SUITE 2
EVERETT PA
15537-7022
US

V. Phone/Fax

Practice location:
  • Phone: 814-623-7855
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD042789E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: