MS. MADELEINE O. KENNEDY


Address: 455 Philip Blvd Ste 200, Lawrenceville, GA 30046-8766
Phone: 7703636096

MS. MADELEINE O. KENNEDY (NPI# 1932612538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932612538
Entity Type Individual
Full Name MS. MADELEINE O. KENNEDY
Credential NP
Practice Address 455 Philip Blvd Ste 200
Lawrenceville
GA 30046-8766
Mailing Address 2003 Arbor Springs Way
Buford
GA 30519-2286
Practice Telephone 7703636096
Enumeration Date 2017-11-06
Last Update Date 2017-11-06
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
RN173803 GA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 455 PHILIP BLVD STE 200
City LAWRENCEVILLE
State GA
Zip Code 30046-8766

Providers in the same location

NPI Name Taxonomy Address Enumeration
1780631689 Atlanta Vamc Clinic/Center 455 Philip Blvd Ste 200, Lawrenceville, GA 30046-8766 2006-05-27

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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1043828106 Shonkeisha Byrd Nurse Practitioner 1160 Great River Pkwy, Lawrenceville, GA 30045-7015 2020-07-15

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NPI Name Taxonomy Address Enumeration
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1588277867 Saleta Anica Brogdon Nurse Practitioner 10 Muirfield Dr, Covington, GA 30016-6536 2020-08-26
1558982272 Irene Kamau Nurse Practitioner 3605 Glenbarrett Ln Ne, Marietta, GA 30066-8509 2020-05-05
1891324133 Branette Young Nurse Practitioner 1120 Lehavre Ct, Hampton, GA 30228-3022 2020-04-08
1851938559 Sandra Holloway Nurse Practitioner 607 Bethany St, Sparks, GA 31647-7139 2019-12-02
1013550508 Monica Smart Mills Nurse Practitioner 8315 Champion Trl, Fairburn, GA 30213-4739 2019-10-28
1063053478 Emily Elizabeth Adams Nurse Practitioner 887 W Marietta St Nw, Atlanta, GA 30318-5252 2019-10-07
1922661800 Dorcus Healthcare Services LLC Nurse Practitioner 105 Greystone Dr, Guyton, GA 31312-5548 2019-04-17
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Competitor

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City LAWRENCEVILLE
Zip Code 30046

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Dataset Information

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.

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