Kennedy, Michelle Lynn

Kennedy, Michelle Lynn is an individual health care provider with primary practice located at 51 N Elm St , Waterbury CT 06702-1511. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kennedy, Michelle Lynn can be contacted via phone (203) 574-4000.

Contact Information

Primary practice address
51 N Elm St Waterbury CT 06702-1511
Phone: (203) 574-4000
Fax: (203) 574-4003
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 16084 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3620 Connecticut

Profile Details

NPI number 1891836110
LBN Legal business name Kennedy, Michelle Lynn
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2007
Last updated Nov 1st, 2011 - about 13 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 1891836110 NPPES
Connecticut MEDICAID 004236346

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