Provider Demographics
NPI:1548026354
Name:KENNY, LORI SHARON (APRN, CNM)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:SHARON
Last Name:KENNY
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-3768
Mailing Address - Country:US
Mailing Address - Phone:830-743-1832
Mailing Address - Fax:
Practice Address - Street 1:1860 GREENFIELD DR
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-3768
Practice Address - Country:US
Practice Address - Phone:830-743-1832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1140496163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient