Provider Demographics
NPI:1679564751
Name:KENNEY, MINH
Entity type:Individual
Prefix:
First Name:MINH
Middle Name:
Last Name:KENNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 681708
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068
Mailing Address - Country:US
Mailing Address - Phone:615-772-5612
Mailing Address - Fax:
Practice Address - Street 1:1310 24TH AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212
Practice Address - Country:US
Practice Address - Phone:615-321-6368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-29
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-126812085R0202X
TNMD00000416302085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology