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Diane Marie Kennedy, NP
Family Nurse Practitioner in Tracy, California
NPI 1972013597

Diane Marie Kennedy is a Family Nurse Practitioner based in Tracy, CA and is specialized in Family. Diane Marie Kennedy practices in Tracy, CA and has the professional credentials of NP. The NPI Number for Diane Marie Kennedy is 1972013597 and holds a License No. 95006559 (California).

The current practice location address for Diane Marie Kennedy is 2185 W Grant Line Rd, Tracy, CA and can be reached out via phone at 209-839-6231.

Location: 2185 W Grant Line Rd, Tracy, CA, 95377-7309
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1972013597
Provider Name
Diane Marie Kennedy
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
2185 W Grant Line Rd, Tracy, CA, 95377-7309
Phone Number
209-839-6231
Fax Number
Provider Enumeration Date
10/10/2017
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
941105628 05 CA
institution
Provider Business Practice Location Address Details
Address
2185 W Grant Line Rd
City
Tracy
State
California
Zip
95377-7309
Phone Number
209-839-6231
Fax Number
person
Provider Business Mailing Address Details
Address
2185 W Grant Line Rd
City
Tracy
State
California
Zip
95377-7309
Phone Number
209-839-6231
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
95006559 (California)
Definition
Definition to come...
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