Provider Demographics
NPI:1528851961
Name:KENNEDY, VANESSA JEAN (CPRS)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:JEAN
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CHRISTOPHER WAY
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3346
Mailing Address - Country:US
Mailing Address - Phone:732-773-0353
Mailing Address - Fax:
Practice Address - Street 1:40 CHRISTOPHER WAY
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3346
Practice Address - Country:US
Practice Address - Phone:732-773-0353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator