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

Nicollette Kennedy

Individual provider Prevention Professional · NPI 1578303574

Nicollette Kennedy is a Prevention Professional in Tahlequah, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2024.

Licensed in
OK
In the registry since
2024

Practice location Address checks out

16414 W 760 Rd
Tahlequah, OK 74464-1675
Phone: (918) 822-1191
Show map & directions

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

Specialties & licences

Prevention Professional (primary) Taxonomy 405300000X · Licence K083179009 (OK)

Record details

NPI number1578303574
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 28, 2024
Last updated in NPPESMay 28, 2024
Certification dateMay 28, 2024
Mailing address16414 W 760 Rd, Tahlequah, OK 74464-1675