IndividualActive
Nicollette Kennedy
NPI 1578303574 · Prevention Professional · Tahlequah, OK
Provider details
- NPI number
- 1578303574
- Entity type
- Individual
- Primary specialty
- Prevention ProfessionalOther Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- K083179009 (OK)
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
16414 W 760 Rd
Tahlequah, OK 74464-1675
Phone: (918) 822-1191
Approximate (ZIP-level) locationGet directions
Mailing address
16414 W 760 Rd
Tahlequah, OK 74464-1675
Registry dates
- Enumerated
- 2024-05-28
- Last updated
- 2024-05-28
- Certified
- 2024-05-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.