Provider Demographics
NPI:1023702495
Name:KENNEDY, LAYET LUCY
Entity type:Individual
Prefix:
First Name:LAYET
Middle Name:LUCY
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SUMMIT CIR NW
Mailing Address - Street 2:
Mailing Address - City:BONDURANT
Mailing Address - State:IA
Mailing Address - Zip Code:50035-1426
Mailing Address - Country:US
Mailing Address - Phone:515-721-4494
Mailing Address - Fax:
Practice Address - Street 1:120 SUMMIT CIR NW
Practice Address - Street 2:
Practice Address - City:BONDURANT
Practice Address - State:IA
Practice Address - Zip Code:50035-1426
Practice Address - Country:US
Practice Address - Phone:515-721-4494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)