NPI 1578303574

Nicollette Kennedy

Practitioner Prevention Professional Tahlequah, OK

Practice location

Address: 16414 W 760 Rd, Tahlequah, OK 74464-1675
Phone: (918) 822-1191

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence K083179009 (OK)

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Registry record

NPI: 1578303574
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 May 2024
Record last updated: 28 May 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.