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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

SECRET ANGEL KENNEDY
NPI 1396675286
Licensed Practical Nurse in Watertown, NY

Active since May 21, 2026
650 STATE ST, WATERTOWN, NY 13601(315) 755-1251(315) 291-6601 Get Directions Write a Review

NPPES record added: May 21, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Secret Angel Kennedy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SECRET ANGEL KENNEDY (NPI 1396675286) is an individual licensed practical nurse in Watertown, New York, licensed in New York (354217) and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1396675286
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameSECRET ANGEL KENNEDY
Location Address650 STATE STWatertown, NY 13601-2839
Mailing Address324 County Route 51 Bldg 1Malone, NY 12953-4502 · (518) 483-1251 · Fax (518) 483-2242
Phone(315) 755-1251
Fax(315) 291-6601
Sole ProprietorNo
Enumeration DateMay 21, 2026
NPPES CertifiedMay 21, 2026
✔ NPI 1396675286 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in NY · 354217
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
650 STATE ST, Watertown, NY 13601
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENZIE AUGUSTUS SOCIAL WORKER
Social Worker
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
MIRIAH KRISTINE QUESENBERRY
Registered Nurse
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
ANGEL J SHEPHERD
Licensed Practical Nurse
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
SABRINA KAY MADDEN RN
Registered Nurse
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
YANILIS ARROYO CRUZ
Student in an Organized Health Care Education/Training Program
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
NATALIE RIVELLLI MHC
Counselor (Mental Health)
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
EMILY LANTRY
Peer Specialist
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
ARIANNA ELISE BARKER I
Case Manager/Care Coordinator
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Secret Kennedy's NPI number?

The NPI number for Secret Kennedy is 1396675286. It was assigned to this individual provider in the NPPES registry on May 21, 2026.

Where is Secret Kennedy located?

Secret Kennedy practices at 650 State St, Watertown, NY 13601. The listed phone number is (315) 755-1251.

What is Secret Kennedy's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Secret Kennedy was last updated on May 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.