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Contact Information

ALLIE KENNEDY
1919 S WHEELING AVE STE 500
TULSA, OK74104-5634
 Phone: 918-403-6284
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for ALLIE KENNEDY · (Female)

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
  • OK License # 4763
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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