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General NPI Number Information
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NPI Number | 1043101777
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Entity Type | Individual
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Provider Name | KENNEDY PARHAM WHNP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 1120 E GENESEE ST
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City | SYRACUSE
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State | NY
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Zip | 13210-1994
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Country | US
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Telephone | 866-600-6886
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Fax | 315-475-5554
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Provider Business Mailing Address
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Address Line | 114 UNIVERSITY AVE
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City | ROCHESTER
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State | NY
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Zip | 14605-2992
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Country | US
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Telephone | 315-496-3824
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Fax | 585-546-5639
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 986991
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 421876
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License Number State | NY
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