Nurse Practitioner, Pediatrics
KATHLEEN ENNIS NP
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1407430341 · enumerated 2021-05-06 · record updated 2023-06-15. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Mailing address 38 SENECA ST, BALDWINSVILLE, NY, 13027 Google Maps Apple Maps OpenStreetMap
- Practice location 4900 BROAD RD, SYRACUSE, NY, 13215-2265 (315) 492-5011 Google Maps Apple Maps OpenStreetMap
Specialties
- Registered Nurse, Neonatal Intensive Care 163WN0002X · License 773322 NY
- Nurse Practitioner, Pediatrics 363LP0200X · Primary · License 383572 NY
In this directory
Locations and evidence
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Practice location
SYRACUSE, NY, 132152265
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.