LISA KENNEDY (NPI# 1710296009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710296009 |
| Entity Type | Individual |
| Full Name | LISA KENNEDY |
| Credential | RD, LD |
| Practice Address |
4635 Ne Stallings Dr Ste 104 Nacogdoches TX 75965 |
| Mailing Address |
Po Box 538 Etoile TX 75944-0538 |
| Practice Telephone | 9366289123 |
| Mailing Telephone | 9366289123 |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2018-08-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | DT07616 | TX | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134752579 | Lisa Kennedy | Peer Specialist | 132 Ne B St # 24, Grants Pass, OR 97526-2114 | 2020-02-13 |
| 1407822265 | Lisa A Kennedy | Optometrist | 4515 Southlake Pkwy, Birmingham, AL 35244-3317 | 2006-02-23 |
| 1831698968 | Lisa M Kennedy | Physical Therapist | 6301 Northumberland St, Pittsburgh, PA 15217-1360 | 2018-02-05 |
| 1356719637 | Lisa Kennedy | Marriage & Family Therapist | 2095 W 6th Ave, Suite 206, Broomfield, CO 80020-1870 | 2015-09-03 |
| 1124422332 | Lisa Kennedy | Counselor | 3525 Colby Ave Ste 200, Everett, WA 98201-4782 | 2014-10-17 |
| 1033519848 | Lisa Kennedy | Audiologist-Hearing Aid Fitter | 974 Sw Veterans Way, Suite 2, Redmond, OR 97756-2564 | 2014-08-28 |
| 1740539238 | Lisa Kennedy | Counselor | 11027 Burbank Blvd, North Hollywood, CA 91601-2431 | 2012-08-30 |
| 1215223508 | Lisa Kennedy | Speech-Language Pathologist | 41 Oconnor Rd, Fairport, NY 14450-1327 | 2011-06-24 |
| 1205136751 | Lisa T Kennedy | Pharmacist | 6460 E Yale Ave, Denver, CO 80222-7156 | 2010-11-01 |
| 1578570743 | Lisa Shea Kennedy | Family Medicine | 430 Boxwood Ln, Pearisburg, VA 24134-1168 | 2006-08-01 |
| Street Address |
4635 NE STALLINGS DR STE 104 |
| City | NACOGDOCHES |
| State | TX |
| Zip Code | 75965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861973091 | Lisa A Kennedy, Rd LLC | Dietitian, Registered | 4635 Ne Stallings Dr Ste 104, Nacogdoches, TX 75965-1667 | 2018-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649839135 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3824 N University Drive, Suite 103, Nacogdoches, TX 75965 | 2019-06-10 |
| 1518520493 | Billy Jobe | Pharmacist | 917 East Austin, Nacogdoches, TX 75965 | 2019-04-17 |
| 1295217610 | Sarah Ponder | Registered Nurse | 625 Woodway Lane, Nacogdoches, TX 75965 | 2018-09-01 |
| 1083107684 | Aakash Deep Gupta | Dentist | 4610 North St Ste 101b, Nacogdoches, TX 75965 | 2018-06-08 |
| 1679097455 | Emily Morris Taravella | Counselor | 3524 Ne Stallings Drive, Nacogdoches, TX 75965 | 2017-08-02 |
| 1457809949 | Kassey Osborn | Nurse Practitioner | 4920 Ne Stallings Dr., Nacogdoches Medical Center, Nacogdoches, TX 75965 | 2016-09-14 |
| 1629426747 | Lisa Greathouse | Technician, Other | 500 Chincapin, Westville, OK 75965 | 2016-05-31 |
| 1457741704 | Nuch of Texas | Pediatrics | 1305 North Street, Nacogdoches, TX 75965 | 2015-01-26 |
| 1730506031 | Benjamin Patrick Thompson | Obstetrics & Gynecology | 4800 Ne Stallings Dr Ste 106, Nacogdoches, TX 75965 | 2014-03-25 |
| 1255761813 | Kallie Krawietz | Counselor | 2214 N Pecan Street, Nacogdoches, TX 75965 | 2013-11-19 |
| Find all providers in zip 75965 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770147852 | Sarah Elizabeth Bullard | Dietitian, Registered | 409 E Lakewood St, Nacogdoches, TX 75965-2531 | 2019-04-24 |
| 1730638164 | Marie Collins Custead | Dietitian, Registered | Sfa Athletic Fieldhouse 712 Hayter St, Nacogdoches, TX 75962-0001 | 2016-09-27 |
| 1184025694 | Timothy Scallon | Dietitian, Registered | 231 County Road 2322, Nacogdoches, TX 75961-8823 | 2014-09-16 |
| 1790113736 | Jennifer Boynton | Dietitian, Registered | 712 Hayter 13010 Sfa Sta, Nacogdoches, TX 75962-0001 | 2013-10-30 |
| 1235446998 | Caroline Sullivan | Dietitian, Registered | 3622 Colony Creek Dr, Nacogdoches, TX 75965-6976 | 2010-09-01 |
| 1164579256 | Kathy C Conyer | Dietitian, Registered | 651 County Road 811, Nacogdoches, TX 75964-2711 | 2007-01-04 |
| 1699258608 | Hallie Bernard | Dietitian, Registered | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2018-09-14 |
| 1861973091 | Lisa A Kennedy, Rd LLC | Dietitian, Registered | 4635 Ne Stallings Dr Ste 104, Nacogdoches, TX 75965-1667 | 2018-08-26 |
| 1346786258 | Hannah Dunahoe | Dietitian, Registered | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2017-01-16 |
| 1629481932 | Jennifer Raegan Best | Dietitian, Registered | 4920 Ne Stallings Dr, Nacogdoches, TX 75965-1254 | 2014-06-04 |
| Find all providers in NACOGDOCHES | ||||
| City | NACOGDOCHES |
| Zip Code | 75965 |
Please comment or provide details below to improve the information on LISA KENNEDY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.