Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackie Kennedy

Individual provider Physician Assistant · NPI 1730497918

Jackie Kennedy is a Physician Assistant in Washington, District of Columbia. Practices as a sole proprietor. Licensed in Georgia, Maryland, North Carolina and Virginia.

Licensed in
GA, MD, NC, VA
In the registry since
2010
Specialties on file
4

Practice location Address checks out

1350 Connecticut Ave NW Ste 1250
Washington, DC 20036-1728
Phone: (888) 663-6331
Fax: (415) 252-7176
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110-007135 (VA)
Physician Assistant Taxonomy 363A00000X · Licence 10296 (GA)
Physician Assistant Taxonomy 363A00000X · Licence 1093616 (MD)
Physician Assistant Taxonomy 363A00000X · Licence 0010-11122 (NC)

Record details

NPI number1730497918
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 21, 2010
Last updated in NPPESMarch 17, 2025
Certification dateMarch 17, 2025

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