National Provider Identifier Database

KATHLEEN D ENNIS, NP – NPI #1407430341
Pediatrics


Contact Information

KATHLEEN D ENNIS, NP
4900 BROAD RD
SYRACUSE, NY13215-2265
Phone: 315-492-5011
Fax:
Website:
Specialty Taxonomy Code
* Pediatrics 363LP0200X
Neonatal Intensive Care 163WN0002X

* Indicates primary specialty

NPI Profile & details for KATHLEEN D ENNIS

NPI Number 1407430341
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 05/06/2021
Last updated 06/15/2023 - About 3 years ago
Sole proprietor1 Yes
Identifiers
  • NY License #: 383572
  • NY License #: 773322
Hospital affiliation n/a

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.

Reviews for KATHLEEN D ENNIS, NP

There are currently no reviews for KATHLEEN D ENNIS, NP


NPIdb - Home
v2.201