Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 13883 | OK |
NPI | 1053429159 |
---|---|
Provider Name | Dr. Diana L. Kennedy |
First Address | Oklahoma City, OK 73120-8347 |
Second Address | Oklahoma City, OK 73120-8347 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 24/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D34889 | (02) | OK |