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General NPI Number Information
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NPI Number | 1528031549
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Entity Type | Individual
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Provider Name | SEAN CHRISTOPHER KENNY
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Gender | Male
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 03/15/2013
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Provider Practice Location Address
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Address Line | 2301 8TH AVE NE STE 225
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City | ABERDEEN
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State | SD
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Zip | 57401-3253
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Country | US
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Telephone | 605-229-3510
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 8TH AVE NE STE 225
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City | ABERDEEN
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State | SD
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Zip | 57401-3253
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0470
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License Number State | SD
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