Healthcare Provider Details

I. General information

NPI: 1467367896
Provider Name (Legal Business Name): ELAINE JOY KENNY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 JOY ALFORD WAY
CARTHAGE TN
37030-3047
US

IV. Provider business mailing address

2005 KIMBERLY DR
MT JULIET TN
37122-4211
US

V. Phone/Fax

Practice location:
  • Phone: 615-735-0242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number296842
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: