Provider Demographics
NPI:1194078295
Name:KENNEY, JULIA ELIZABETH (RN, ANP-BC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ELIZABETH
Last Name:KENNEY
Suffix:
Gender:F
Credentials:RN, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 PELHAM ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-2514
Mailing Address - Country:US
Mailing Address - Phone:774-217-1246
Mailing Address - Fax:
Practice Address - Street 1:9 SUMMER ST
Practice Address - Street 2:SUITE 302
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-1491
Practice Address - Country:US
Practice Address - Phone:508-507-8818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA270188363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health