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BRENDA A KENNEDY APN

Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Medical

Provider NPI: 1164502290

Provider Information:
 BRENDA A KENNEDY APN
Gender: F
Not Sole Proprietor

Practice Location:
434 HWY 18 BYPASS  MANILA, AR 72442 US
Tel: 870-561-3300  Fax: 870-561-3307

Business Mailing Address:
PO BOX 910  MANILA, AR 72442-0910 US
Tel: 870-561-3300  Fax: 870-561-3307

NPI Information:
NPI: 1164502290
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
ARA01337

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 363AM0700X

Type:

Classification:



Definition:



MEDICAL JOBS AR - Page 1

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