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Marie Antoinette Kennedy
Nurse Practitioner in Mishawaka, Indiana
NPI 1851899140

Marie Antoinette Kennedy is a Nurse Practitioner based in South Bend, IN. Marie Antoinette Kennedy practices in Mishawaka, IN. The NPI Number for Marie Antoinette Kennedy is 1851899140 and holds a License No. 71007869A (Indiana).

The current practice location address for Marie Antoinette Kennedy is 611 E Douglas Rd Ste 208, Mishawaka, IN and can be reached out via phone at 574-335-6000 and via fax at 574-335-0738. You can also correspond with Marie Antoinette Kennedy through the mailing address at 707 CEDAR ST STE 200, SOUTH BEND, IN - 46617-2057 (mailing address contact number: 574-335-8707).

Location: 611 E Douglas Rd Ste 208, Mishawaka, IN, 46617-2057
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1851899140
Provider Name
Marie Antoinette Kennedy
Credential
Provider Entity Type
Individual
Gender
Female
Address
611 E Douglas Rd Ste 208, Mishawaka, IN, 46617-2057
Phone Number
574-335-6000
Fax Number
574-335-0738
Provider Enumeration Date
02/01/2018
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
611 E Douglas Rd Ste 208
City
Mishawaka
State
Indiana
Zip
46545-1465
Phone Number
574-335-6000
Fax Number
574-335-0738
person
Provider Business Mailing Address Details
Address
707 Cedar St Ste 200
City
South Bend
State
Indiana
Zip
46617-2057
Phone Number
574-335-8707
Fax Number
574-335-0741
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
28143781A (Indiana)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
363LG0600X
License No.
71007869A (Indiana)
Definition
Definition to come...
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