Provider Demographics
NPI:1750094546
Name:KENNEDY, JULIE DEE (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:DEE
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 COUNTRY DAY TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-1048
Mailing Address - Country:US
Mailing Address - Phone:817-266-8795
Mailing Address - Fax:
Practice Address - Street 1:10260 N CENTRAL EXPY STE 210
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3426
Practice Address - Country:US
Practice Address - Phone:469-729-6460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1102276363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily