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NPI Code Detail

MEDICARE: MR. LAWRENCE AVERY KENNARD FNP

MEDICARE: MR. LAWRENCE AVERY KENNARD FNP
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
1363LF0000XFamily Nurse PractitionerCP001552SD
2363LF0000XFamily Nurse Practitioner225556AZ
3363LF0000XFamily Nurse Practitioner5452MN
4363LF0000XFamily Nurse Practitioner25267TN

General Provider Information

NPI Number : 1558872531
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LAWRENCE AVERY KENNARD FNP
Provider Business Mailing Address
First Line : 261 EPLEY RD
Second Line :
City : NEWPORT
State : TN
Zip : 37821-7234
Country : US
Telephone Number : 865-805-3571
Fax Number :
Provider Business Practice Location Address
First Line : 121 NEWPORT TOWNE CTR
Second Line :
City : NEWPORT
State : TN
Zip : 37821-7391
Country : US
Telephone Number : 423-532-8621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2017
Last Update Date : 07/23/2025

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