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General NPI Number Information
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NPI Number | 1508436197
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Entity Type | Individual
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Provider Name | KENNEDI PAIGE HARRISON NP
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Gender | Female
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 926 N MICHIGAN AVE
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City | SAGINAW
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State | MI
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Zip | 48602-4323
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Country | US
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Telephone | 989-753-8453
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Fax | 989-755-9983
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Provider Business Mailing Address
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Address Line | 926 N MICHIGAN AVE
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City | SAGINAW
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State | MI
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Zip | 48602-4323
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Country | US
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Telephone | 989-753-8453
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Fax | 989-755-9983
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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 | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 4704348687
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License Number State | MI
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