Kennedy, Kathleen Dacuk Rose

Kennedy, Kathleen Dacuk Rose is an individual health care provider with primary practice located at 1701 Thomson Dr , Lynchburg VA 24501-1118. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Kennedy, Kathleen Dacuk Rose can be contacted via phone (434) 200-4010.

Contact Information

Primary practice address
1701 Thomson Dr Lynchburg VA 24501-1118
Phone: (434) 200-4010
Fax: (434) 200-7400
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 0001096751 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 0024096751 Virginia

Profile Details

NPI number 1396754362
LBN Legal business name Kennedy, Kathleen Dacuk Rose
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2006
Last updated Jan 26th, 2016 - about 8 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 1396754362 NPPES
Virginia MEDICAID 7782951

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