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General NPI Number Information
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NPI Number | 1154374478
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Entity Type | Individual
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Provider Name | BONNIE KENNEDY APRN, BC, P.A.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 186 BURNETTE CIR
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City | WAYNESVILLE
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State | NC
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Zip | 28786-7520
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Country | US
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Telephone | 336-209-3568
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Fax | 323-366-2966
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Provider Business Mailing Address
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Address Line | 3518 DRAWBRIDGE PKWY
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City | GREENSBORO
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State | NC
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Zip | 27410-8432
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Country | US
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Telephone | 336-209-3568
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Fax | 336-540-1095
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 090018
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License Number State | NC
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