Healthcare Provider Details

I. General information

NPI: 1619446069
Provider Name (Legal Business Name): EMILY E KENNEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1361 HERO WAY STE 101
LEANDER TX
78641-5579
US

IV. Provider business mailing address

PO BOX 10597
AUSTIN TX
78766-1597
US

V. Phone/Fax

Practice location:
  • Phone: 512-244-2273
  • Fax: 512-244-3179
Mailing address:
  • Phone: 512-420-0186
  • Fax: 903-200-5107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP138277
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP138277
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: