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General NPI Number Information
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NPI Number | 1487188850
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Entity Type | Individual
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Provider Name | LIANNE KENNEDY FNP
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Gender | Female
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 04/14/2021
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Provider Practice Location Address
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Address Line | 2417 ATRIUM DR SUITE 150
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City | RALEIGH
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State | NC
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Zip | 27607-0161
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Country | US
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Telephone | 919-791-2040
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Fax | 919-791-2041
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Provider Business Mailing Address
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Address Line | 2417 ATRIUM DR SUITE 150
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City | RALEIGH
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State | NC
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Zip | 27607-0161
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Country | US
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Telephone | 919-791-2040
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Fax | 919-791-2041
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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 | 139744
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License Number State | NC
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