Basic Information
Provider Information
NPI: 1013976331
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KENNEY
FirstName: BARBARA
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 4631 NW 31ST AVE
Address2: C/O ANESCO ANESTHESIA ASSOCIATE
City: FORT LAUDERDALE
State: FL
PostalCode: 333093433
CountryCode: US
TelephoneNumber: 9544855666
FaxNumber: 9544841651
Practice Location
Address1: 5757 NORTH DIXIE HIGHWAY
Address2: C/O NORTH RIDGE MEDICAL CENTER
City: FORT LAUDERDALE
State: FL
PostalCode: 33334
CountryCode: US
TelephoneNumber: 9547766000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/23/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XARNP1348342FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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