KATHLEEN MARIE FENNELLY R.N. N.P NPI 1649262429

NPI Information

NPI: 1649262429
Provider Name: KATHLEEN MARIE FENNELLY, R.N., N.P,
Classification: Nurse Practitioner - 363LX0001X
Entity Type: Individual

Specialization: Obstetrics & Gynecology

Address:
896 E FOOTHILL BLVD
SAN LUIS OBISPO, CA
ZIP 93405
Phone: (805) 542-0900
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Kathleen Marie Fennelly, R.N., N.P, is an obstetrics and gynecology nurse practitioner in San Luis Obispo, CA. Kathleen Marie Fennelly, R.N., N.P, NPI is 1649262429. 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:

896 E FOOTHILL BLVD
SAN LUIS OBISPO, CA
ZIP 93405-761
Phone: (805) 542-0900

The enumeration date for this NPI number is 8/18/2005 and was last updated on 8/6/2009.

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
1	363LX0001X	Nurse Practitioner	Obstetrics & Gynecology	7319	CALIFORNIA	Yes

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
1	456414	OTHER	CALIFORNIA	RN LICENSE #
2	7319	OTHER	CALIFORNIA	NP LICENSE #

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: 4/28/2024

NPI Synchronization or Removal

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