MEDICARE: MS. SHERILL D. KENNEDY MSN, APRN, WHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	AP126787	TX

General Provider Information

NPI Number	:	1063892107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHERILL D. KENNEDY MSN, APRN, WHNP-BC

Provider Business Mailing Address
First Line	:	4137 MCFARLAND DR
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-4078
Country	:	US
Telephone Number	:	330-881-7812
Fax Number	:

Provider Business Practice Location Address
First Line	:	2617 W HOLCOMBE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1757
Country	:	US
Telephone Number	:	281-651-4660
Fax Number	:	281-651-4806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2015
Last Update Date	:	06/03/2015

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