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General NPI Number Information
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NPI Number | 1174315915
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Entity Type | Individual
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Provider Name | MICHELLE LYNN KENNEDY APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 854 W JAMES CAMPBELL BLVD SUITE 100
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City | COLUMBIA
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State | TN
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Zip | 38401
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Country | US
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Telephone | 931-490-7050
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Fax |
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Provider Business Mailing Address
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Address Line | 1904 BURLINGTON CIR
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City | COLUMBIA
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State | TN
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Zip | 38401-6809
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Country | US
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Telephone | 931-628-0661
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 38314
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License Number State | TN
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