Kennedy, Kerry Marie

Kennedy, Kerry Marie is an individual health care provider with primary practice located at 7066 Stillwater Blvd N , Oakdale MN 55128-3937. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Psychiatric/Mental Health, Adult, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Kennedy, Kerry Marie can be contacted via phone (612) 227-3075.

Contact Information

Primary practice address
7066 Stillwater Blvd N Oakdale MN 55128-3937
Phone: (612) 227-3075
Fax: (651) 251-5128
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health, Adult 163WP0809X R123669 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 0908 Minnesota

Profile Details

NPI number 1083949986
LBN Legal business name Kennedy, Kerry Marie
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 9th, 2009
Last updated Jan 26th, 2022 - about 2 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 1083949986 NPPES
Minnesota Other 500005583 MEDICARE PTAN

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