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Tara Ann Kennedy

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

14230 Hunters Rd, Huntersville, NC 28078-7335

PECOS Enrollment

This provider is enrolled in PECOS as TARA KENNEDY.

Based on the most recent information from CMS, provider Tara Ann Kennedy is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 10:49 AM.

Profile Details

Provider ID
1245424761
Provider Type
Individual
Full Name
Kennedy, Tara Ann
Credential
FNP- BC

Gender
Female
Sole Proprietor
No
Enumeration Date
8/28/2007
Last Updated
1/29/2026

Contact Information

Practice Location

14230 Hunters Rd, Huntersville, NC 28078-7335

(704) 316-6611

(704) 316-6612

Mailing Location

14230 Hunters Rd, Huntersville, NC 28078-7335

(704) 316-6611

(704) 316-6612

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 5014370 North Carolina
Code 363L00000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 5014370 North Carolina

Tara Ann Kennedy

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Wiszczur, Jackie Ann

Smith, Marilyn G

Smith, Hannah Lane

Busheva, Mariela Petrova

Fox, Candice L

Slisenko, Anastasia V.

Hanson, Melissa

Lewis, Cassidy Marie

Hartzell, Mary Christine

Ellis, John Steven