MRS. BROOKE ASHTON KENNON DNP APRN AG-ACNP-BC NPI 1972144608

NPI Information

  • NPI: 1972144608
  • Provider Name: MRS. BROOKE ASHTON KENNON, DNP APRN AG-ACNP-BC
  • Classification: Nurse Practitioner - 363LA2100X
  • Specialization: Acute Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6025 WALNUT GROVE RD STE 301
    MEMPHIS, TN
    ZIP 38120
  • Phone: (901) 226-0456

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NPI Details

MRS. Brooke Ashton Kennon, DNP APRN AG-ACNP-BC is an acute care nurse practitioner in Memphis, TN. MRS. Brooke Ashton Kennon, DNP APRN AG-ACNP-BC NPI is 1972144608. 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:

6025 WALNUT GROVE RD STE 301
MEMPHIS, TN
ZIP 38120-123
Phone: (901) 226-0456

The NPI 1972144608 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 10/3/2019 and was last updated on 10/3/2024.

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
1363LA2100XNurse PractitionerAcute Care26355TENNESSEEYes

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
11972144608MEDICAIDTENNESSEE

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: 3/30/2025

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