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General NPI Number Information
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NPI Number | 1518712744
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Entity Type | Individual
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Provider Name | DILLON KENNEDY FNP-C
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Gender | Male
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 804 E LASALLE ST
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City | VILLE PLATTE
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State | LA
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Zip | 70586-4000
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Country | US
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Telephone | 337-317-8781
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Fax |
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Provider Business Mailing Address
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Address Line | 3002 ENGLEWOOD DR
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City | JENNINGS
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State | LA
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Zip | 70546-3266
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Country | US
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Telephone | 337-466-0384
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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 | 234752
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License Number State | LA
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