MS. ELIZABETH ELLEN KENNEDY NPI 1124167861

NPI Information

  • NPI: 1124167861
  • Provider Name: MS. ELIZABETH ELLEN KENNEDY
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • Address: 75 FENWOOD RD.
    MASSACHUSETTS MENTAL HEALTH CENTER
    BOSTON, MA
    ZIP 02115
  • Phone: (617) 626-9326

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NPI Details

MS. Elizabeth Ellen Kennedy is an adult health nurse practitioner in Boston, MA. MS. Elizabeth Ellen Kennedy NPI is 1124167861. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

75 FENWOOD RD.
MASSACHUSETTS MENTAL HEALTH CENTER
BOSTON, MA
ZIP 02115
Phone: (617) 626-9326
Fax: (617) 626-9578

The enumeration date for this NPI number is 2/6/2007 and was last updated on 11/23/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult Health146061MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1KENP4208MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
2P93120MEDICARE UPINMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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