ROBERTA LEE KENNEDY (NPI# 1558513226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558513226 |
| Entity Type | Individual |
| Full Name | ROBERTA LEE KENNEDY |
| Practice Address |
2700 Robert T. Longway Blvd Suite A Flint MI 48503 |
| Practice Telephone | 8102352599 |
| Mailing Telephone | 8102352599 |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2008-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SG0600X |
Clinical Nurse Specialist Specialization: Gerontology |
4704140071 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS GROUP | OB514740 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043568470 | Roberta Kennedy | Physical Therapy Assistant | 3500 Singing Hills Blvd, Sioux City, IA 51106-5127 | 2012-08-15 |
| Street Address |
2700 ROBERT T. LONGWAY BLVD SUITE A |
| City | FLINT |
| State | MI |
| Zip Code | 48503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457971640 | Flint Odyssey House Inc. | Community/Behavioral Health | 1219 Martin Luther King Avenue, Flint, MI 48503 | 2020-04-17 |
| 1891265476 | Mary Margaret Woodruff | Health Educator | 411 E. Third St Suite 2, Flint, MI 48503 | 2018-11-27 |
| 1669942223 | Donna Jean Phelps | Behavior Technician | 2284 S Ballenger Highway, Flint, MI 48503 | 2018-11-27 |
| 1588150601 | Dayonna Scott | Social Worker | Hope Network, 2830 Corunna Rd, Flint, MI 48503 | 2018-07-02 |
| 1801388020 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2284 S Ballenger Hwy Ste F, Flint, MI 48503 | 2018-06-04 |
| 1134610504 | Swathi Gorle | Student in an Organized Health Care Education/Training Program | Hurley Medical Center, 1 Hurley Plaza, Flint, MI 48503 | 2018-05-22 |
| 1881128049 | Kara Garr | Registered Nurse | 805 Tuuri Pl, Flint, MI 48503 | 2017-04-14 |
| 1518405638 | Thomasinia Terrell | Peer Specialist | 422 W Fourth Ave, Flint, MI 48503 | 2017-02-09 |
| 1790231041 | Roslyn Boyce | Technician, Other | 2213 E. Court Street, Flint, MI 48503 | 2016-08-28 |
| 1689120818 | Yasmine Elhefnawy | Student in an Organized Health Care Education/Training Program | One Hurley Plaza 3d West, Flint, MI 48503 | 2016-08-28 |
| Find all providers in zip 48503 | ||||
| Taxonomy Code | 364SG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851941116 | Suzanne Leona Purvis | Clinical Nurse Specialist | 3601 W 13 Mile Rd # Mc305, Royal Oak, MI 48073-6712 | 2019-09-18 |
| 1174055362 | Lilian Paciorkowski | Clinical Nurse Specialist | 4600 Investment Dr Ste 200, Troy, MI 48098-6375 | 2017-03-28 |
| 1700050531 | Ann Holmgren Harris | Clinical Nurse Specialist | 17353 Hazel St, Suite 212, Spring Lake, MI 49456 | 2008-04-14 |
| 1699328393 | Mary Tibbe | Clinical Nurse Specialist | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-07-22 |
| 1861927295 | Taylor Long | Clinical Nurse Specialist | 15855 19 Mile Rd, Clinton Twp, MI 48038-3504 | 2017-04-24 |
| 1093899569 | Baddigam Family Psychiatric Associates Pllc | Clinical Nurse Specialist | 43211 Dalcoma Dr, Ste. 3, Clinton Township, MI 48038-6309 | 2006-10-24 |
| 1508886375 | Erickson Health Medical Group of Michigan PC | Clinical Nurse Specialist | 41100 Fox Run, Novi, MI 48377-4804 | 2006-07-21 |
Please comment or provide details below to improve the information on ROBERTA LEE KENNEDY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.