Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC883 | HI |
NPI | 1013000884 |
---|---|
Provider Name | Dr. Patricia M Kennedy |
First Address | Haleiwa, HI 96712-9752 |
Second Address | Haleiwa, HI 96712-9752 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000254292 | HMSA (01) | HI |
U80004 | (02) |