Provider Demographics
NPI:1972757987
Name:KENNEDY, JOANNE M (RNC-FNP)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:M
Last Name:KENNEDY
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Gender:F
Credentials:RNC-FNP
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Mailing Address - Street 1:260 NEW LUDLOW RD
Mailing Address - Street 2:WESTERN MASS PHYSICIAN ASSOC., INC
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-4324
Mailing Address - Country:US
Mailing Address - Phone:413-533-2452
Mailing Address - Fax:413-533-3624
Practice Address - Street 1:10 HOSPITAL DR
Practice Address - Street 2:SUITE 305
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6643
Practice Address - Country:US
Practice Address - Phone:413-533-2452
Practice Address - Fax:413-533-3624
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2013-05-06
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Provider Licenses
StateLicense IDTaxonomies
MAMA140947363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110094998AMedicaid