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Contact Information

HEATHER C KENNEDY, P.A.-C.
7900 NW 23RD ST
SUITE 1
BETHANY, OK73008-4961
 Phone: 405-470-3232
 Fax: 405-470-3233
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for HEATHER C KENNEDY · (Female)

NPI # 1447596804
Status Active
Credentials P.A.-C.
Entity Individual
Enumeration date 12/12/2012
Last updated 04/26/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 2191
  • PA License # 2191
  • OK Medicaid 200506010A
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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