Mary Carol Patricia Kennedy, MSN RN CS CCDP-D

Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Braddock, PA

NPI 1063674026 · NPPES record last updated Jun 30, 2008

Key facts

NPI
1063674026
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Registered Nurse 163WP0808X
License
RN158452L (PA)
Practice address
723 Braddock Ave
TCV
Braddock, PA 15104-1849
Phone
(412) 824-8510
Fax
(412) 824-0179
NPI assigned
Jun 30, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Specialist, Master of Science - Nursing, Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN158452L PA Yes

Addresses

Primary practice location

723 Braddock Ave
TCV
Braddock, PA 15104-1849

Mailing address

519 Penn Ave
TCV
Turtle Creek, PA 15145-2082
Phone (412) 824-8510

Other providers in Braddock, PA

All providers in Braddock, PA · Psychiatric/Mental Health Registered Nurse in Pennsylvania

Sources for this page

Verify at the official NPI Registry.