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NPI Code Detail

MEDICARE: KENNEDY MICHALINE PERRY APRN

MEDICARE: KENNEDY MICHALINE PERRY APRN
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
1363LA2200XAdult Health Nurse PractitionerAG07240041OH

General Provider Information

NPI Number : 1912737073
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNEDY MICHALINE PERRY APRN
Provider Business Mailing Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-1906
Country : US
Telephone Number : 216-444-6571
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-6571
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2024
Last Update Date : 09/24/2025

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Directions to “ KENNEDY MICHALINE PERRY APRN” Practice Location

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