Kennedy Deslyn Koebbe, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704371010 Issued in MI

Practice address

214 N West Ave
Jackson, MI 49201-1903

Phone

(517) 784-9189

NPI assigned

Jun 4, 2025

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Matt T Rosenberg PC

  • Family Medicine Physician
  • Jackson, MI
  • NPI 1063692556
  NPD

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1790679819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011903",
            "telephone_number": "517-784-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011903",
            "telephone_number": "517-784-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEBBE",
        "first_name": "KENNEDY",
        "middle_name": "DESLYN",
        "name_prefix": "Miss",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704371010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Scott Knipp, M.D.
• Timothy James Knittle II
• Nicole Elizabeth Knoth, PHARMD
• Kenesha Knox
• Aruna Kode, M.D.
• Shelby Marie Koehler
• James G Koffeman, D.C.
• Jennifer Lynn Koffeman, LLMSW
• Hilliary Scarlett Kofflin
• Marieme E Kofflin

• Family Nurse Practitioner in Jackson, MI
• Providers in Jackson, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.