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Mr. Larry Ray Kennon, APRN,BC
Family Nurse Practitioner in West Plains, Missouri
NPI 1003803370

Larry Ray Kennon is a Family Nurse Practitioner based in West Plains, MO and is specialized in Family. Larry Ray Kennon practices in West Plains, MO and has the professional credentials of APRN,BC. The NPI Number for Larry Ray Kennon is 1003803370 and holds a License No. 061052 (Missouri).

The current practice location address for Larry Ray Kennon is 1137 Independence Dr, West Plains, MO and can be reached out via phone at 417-255-8464.

Location: 1137 Independence Dr, West Plains, MO, 65775-6797
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Provider Profile Details
NPI Number
1003803370
Provider Name
Larry Ray Kennon
Credential
APRN,BC
Provider Entity Type
Individual
Gender
Male
Address
1137 Independence Dr, West Plains, MO, 65775-6797
Phone Number
417-255-8464
Fax Number
Provider Enumeration Date
10/03/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000013700 01 MEDICARE GROUP NUMBER
261882 01 MEDICARE FQHC
261863 01 MEDICARE FQHC
428580211 05 MO
institution
Provider Business Practice Location Address Details
Address
1137 Independence Dr
City
State
Zip
65775-4221
Phone Number
417-255-8464
Fax Number
person
Provider Business Mailing Address Details
Address
1137 Independence Dr
City
State
Zip
65775-4221
Phone Number
417-255-8464
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
061052 (Missouri)
Definition
Definition to come...
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