Provider Demographics
NPI:1558872531
Name:KENNARD, LAWRENCE AVERY (FNP)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:AVERY
Last Name:KENNARD
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 EPLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-7234
Mailing Address - Country:US
Mailing Address - Phone:865-805-3571
Mailing Address - Fax:
Practice Address - Street 1:121 NEWPORT TOWNE CTR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-7391
Practice Address - Country:US
Practice Address - Phone:423-532-8621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5452363LF0000X
NC63TT40363LF0000X
NC5009977363LF0000X
TN25267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily