Provider Demographics
NPI:1124816657
Name:KENNEDY, VICTOR LAVELL I
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:LAVELL
Last Name:KENNEDY
Suffix:I
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7604 GREENLAND PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-2710
Mailing Address - Country:US
Mailing Address - Phone:513-435-2441
Mailing Address - Fax:
Practice Address - Street 1:7604 GREENLAND PL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-2710
Practice Address - Country:US
Practice Address - Phone:513-435-2441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty