MEDICARE: BARBARA J KENNEDY APN,C

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	363LF0000X	Family Nurse Practitioner	26NN09780200	NJ

General Provider Information

NPI Number	:	1467406769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA J KENNEDY APN,C

Provider Business Mailing Address
First Line	:	616 W VERNON AVE
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1323
Country	:	US
Telephone Number	:	609-645-7700
Fax Number	:	609-272-8490

Provider Business Practice Location Address
First Line	:	201 SHORE RD
Second Line	:
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-2319
Country	:	US
Telephone Number	:	609-645-7700
Fax Number	:	609-272-8490

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	07/08/2007

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