Kennedy, Christopher Andrew

Kennedy, Christopher Andrew is an sole proprietor health care provider with primary practice located at 300 Corporate Center Drive , Scott Depot WV 25560. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Kennedy, Christopher Andrew can be contacted via phone (304) 691-6800.

Contact Information

Primary practice address
300 Corporate Center Drive Scott Depot WV 25560
Phone: (304) 691-6800
Fax: (304) 691-6751
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 01012 West Virginia

Profile Details

NPI number 1255317640
LBN Legal business name Kennedy, Christopher Andrew
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 19th, 2005
Last updated Dec 20th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255317640 NPPES
West Virginia MEDICAID 3810006501

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