Provider Information for 1154001212
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Mrs. TABATHA FRANKLIN KENNEY
Sex: Female
NPI: 1154001212
Last Updated: 2023-07-24
Certification Date: 2023-07-22
Certification Date: 2023-07-22
Details
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NPI | 1154001212 | ||||||||
Enumeration Date | 2023-07-24 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 617 KINSINGTON CT RIDGELAND, MS 39157-4185 United States Phone: 601-946-4632 | Fax: | ||||||||
Primary Practice Address | 617 KINSINGTON CT RIDGELAND, MS 39157-4185 United States Phone: 601-946-4632 | Fax: | ||||||||
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