Jacqueline Marie Kennedy

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1101629 Issued in KY

Practice address

4001 Dutchmans LN
Louisville, KY 40207-4714

Phone

(502) 893-1277

NPI assigned

Dec 8, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1588108674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WILSONVILLE HEIGHTS DR",
            "city": "FISHERVILLE",
            "state": "KY",
            "postal_code": "400237521",
            "telephone_number": "502-492-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 DUTCHMANS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074714",
            "telephone_number": "502-893-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1101629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia P Kennebrew
• Angela Kennedy, PHARMD
• Claire Kennedy
• Erica Lee Kennedy, SLP
• Hailie Suzanne Kennedy, LPCC
• Janet M Kennedy, APRN
• Kimberly Kristine Kennedy, ARNP
• Krista Kennedy
• Mary A Kennedy, M.S.,CCC-SLP
• Mary E Kennedy, LCSW

• Registered Nurse in Louisville, KY
• Providers in Louisville, KY by specialty
• Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.