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Contact Information

KEITH W JENNINGS, PhD
2817 REILLY ROAD
WOMACK ARMY MEDICAL CENTER
FORT BRAGG, NC28307
 Phone: 910-243-9262
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for KEITH W JENNINGS · (Male)

NPI Number 1922479641
Status Active
Credentials PhD
Entity Individual
Enumeration date 10/08/2015
Last updated 11/06/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 5042
  • VA License # 0810005241
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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