Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MT185924 | PA |
N | 207XS0106X | Orthopaedic Hand Surgeon | 13225 | RI |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 247594 | MA |
NPI | 1043370604 |
---|---|
Provider Name | Dr. Julia Anne Kenniston |
First Address | Duxbury, MA 02332-4738 |
Second Address | Plymouth, MA 02360-4842 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 01/06/2020 |