Kennedy, Sheila

Kennedy, Sheila is an individual health care provider with primary practice located at 1430 Five Forks Trickum Rd St 220 , Lawrenceville GA 30044-8182. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Kennedy, Sheila can be contacted via phone (678) 578-4983.

Contact Information

Primary practice address
1430 Five Forks Trickum Rd St 220 Lawrenceville GA 30044-8182
Phone: (678) 578-4983
Fax: (678) 578-4988
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 68227 Georgia
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X New Jersey

Profile Details

NPI number 1013148626
LBN Legal business name Kennedy, Sheila
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2009
Last updated Apr 9th, 2015 - about 10 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 1013148626 NPPES
Georgia MEDICAID 003140093B
Georgia MEDICAID 003140093A

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