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General NPI Number Information
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NPI Number | 1093527012
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Entity Type | Individual
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Provider Name | DIANA LEWIS KENNEDY RN
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Gender | Female
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Dates
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Enumeration Date | 01/25/2025
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Last Update Date | 01/25/2025
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Provider Practice Location Address
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Address Line | 2400 CANAL ST
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City | NEW ORLEANS
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State | LA
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Zip | 70119-6535
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Country | US
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Telephone | 800-935-8387
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Fax |
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Provider Business Mailing Address
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Address Line | 1509 ADMIRAL NELSON DR
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City | SLIDELL
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State | LA
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Zip | 70461-4506
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Country | US
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Telephone | 504-224-3177
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Fax |
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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 | 364SM0705X
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Taxonomy Name | Medical-Surgical Clinical Nurse Specialist
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License Number | RN158151
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License Number State | LA
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