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Contact Information

STACEY C KENNON, MD
HOLLISTON PEDIATRIC GROUP
100 JEFFREY AVE.
HOLLISTON, MA01746
 Phone: 508-429-2800
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for STACEY C KENNON · (Female)

NPI Number 1356375018
Status Active
Credentials MD
Entity Individual
Enumeration date 07/10/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 73391
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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