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NPI Code Detail

MEDICARE: KENNEDY DAWN PERRINE

MEDICARE: KENNEDY DAWN PERRINE
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
1363A00000XPhysician AssistantGA

General Provider Information

NPI Number : 1114860392
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNEDY DAWN PERRINE
Provider Business Mailing Address
First Line : 8048 HIGHLANDS DR
Second Line :
City : MIDLAND
State : GA
Zip : 31820-4275
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 WASHINGTON ST SE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3628
Country : US
Telephone Number : 706-315-3982
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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Directions to “ KENNEDY DAWN PERRINE ” Practice Location

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