Kennedy, Justin Michael

Kennedy, Justin Michael is an individual health care provider with primary practice located at 2020 W St Hwy 114 Suite 120, Grapevine TX 76051-8649. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Kennedy, Justin Michael can be contacted via phone (817) 912-8300.

Contact Information

Primary practice address
2020 W St Hwy 114 Suite 120 Grapevine TX 76051-8649
Phone: (817) 912-8300
Fax: (817) 912-8310
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X

Profile Details

NPI number 1528415767
LBN Legal business name Kennedy, Justin Michael
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2016
Last updated Aug 21st, 2016 - about 9 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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