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General NPI Number Information
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NPI Number | 1699724344
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Entity Type | Individual
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Provider Name | BETTY ANN ANDRADE-KENNEDY LPN
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Gender | Female
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9353 DANCING DAFFODIL AVE
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City | LAS VEGAS
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State | NV
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Zip | 89129-6988
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Country | US
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Telephone | 702-360-0589
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Fax | 302-380-0589
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Provider Business Mailing Address
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Address Line | 450 N NELLIS BLVD #168
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City | LAS VEGAS
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State | NV
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Zip | 89110-5304
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Country | US
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Telephone | 702-354-6635
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Fax | 302-380-0589
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN11745
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License Number State | NV
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