NPI Profile for ALLIE KENNEDY in TULSA, OK.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant | |
Student in an Organized Health Care Education/Training Program |
390200000X |
| NPI Number | 1689216251 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 10/15/2019 | |
| Last updated | 03/24/2022 - About 4 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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ALLIE KENNEDY
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