Newly enumerated
The official enumeration date falls within the documented new-enumeration window.
- Enumeration date is 35 days before observation
Type 1 individualNPI 1679409510
SHANNON KENNEDY
172V00000X · VAIL, AZ
Why this profile is appearing now
Observed change signals
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 172V00000X | 172V00000X | Primary |
| 3747P1801X | 3747P1801X | Additional |
| 374U00000X | 374U00000X | Additional |
| 376J00000X | 376J00000X | Additional |
| 376K00000X | 376K00000X | Additional |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s