MRS. MICHELLE LYNN KENNEDY NP NPI 1891836110

NPI Information

NPI: 1891836110
Provider Name: MRS. MICHELLE LYNN KENNEDY, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
51 N ELM ST
WATERBURY, CT
ZIP 06702
Phone: (203) 574-4000
Get Directions

MRS. Michelle Lynn Kennedy, NP is a family nurse practitioner in Waterbury, CT. MRS. Michelle Lynn Kennedy, NP NPI is 1891836110. 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:

51 N ELM ST
WATERBURY, CT
ZIP 06702-511
Phone: (203) 574-4000
Fax: (203) 574-4003

The NPI 1891836110 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/9/2007 and was last updated on 11/1/2011.

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
1	363LF0000X	Nurse Practitioner	Family	16084	CALIFORNIA	No
2	363LF0000X	Nurse Practitioner	Family	3620	CONNECTICUT	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	004236346	MEDICAID	CONNECTICUT

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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