Provider Demographics
NPI:1932928637
Name:KENNEDY, TAUREEN (LPN)
Entity type:Individual
Prefix:
First Name:TAUREEN
Middle Name:
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3744 FAIRWAY PARK DR APT 206
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-3112
Mailing Address - Country:US
Mailing Address - Phone:330-957-1065
Mailing Address - Fax:
Practice Address - Street 1:3744 FAIRWAY PARK DR APT 206
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-3112
Practice Address - Country:US
Practice Address - Phone:330-957-1065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH185188164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse