KATHLEEN DANIELLE ENNIS NP
NPI 1407430341
Nurse Practitioner - Pediatrics in Syracuse, NY

Active since May 06, 2021
4900 BROAD RD, SYRACUSE, NY 13215(315) 492-5011 Get Directions Write a Review

NPPES record last updated: June 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 15, 2023, Jun 9, 2023, May 6, 2021 (3 updates tracked since 2021).

About Kathleen Danielle Ennis Np NPPES

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

KATHLEEN DANIELLE ENNIS NP (NPI 1407430341) is an individual pediatrics provider in Syracuse, New York, licensed in New York (383572) and active in the NPI registry since May 2021. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1407430341
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameKATHLEEN DANIELLE ENNISCredential: NP
Location Address4900 BROAD RDSyracuse, NY 13215-2265
Mailing Address38 Seneca StBaldwinsville, NY 13027
Sole ProprietorYes
Enumeration DateMay 6, 2021
Last NPPES UpdateJune 15, 20233 updates tracked since enumeration
NPPES CertifiedJune 15, 2023
NPI 1407430341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License Licensed in NY · 383572
Also ListedRegistered Nurse · Neonatal Intensive CareTaxonomy 163WN0002X · License 773322 (NY)
4900 BROAD RD, Syracuse, NY 13215

Secondary Practice Locations 2

Location 197 Patricia DrSyracuse, NY 13212-4272 · Phone (315) 383-5050
Location 238 Seneca StBaldwinsville, NY 13027-2809 · Phone (315) 559-1371

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.

Occupational Therapist
4900 BROAD RD
SYRACUSE, NY 13215
Nurse Anesthetist, Certified Registered
4900 BROAD RD
SYRACUSE, NY 13215
Nurse Anesthetist, Certified Registered
4900 BROAD RD
SYRACUSE, NY 13215
Nurse Anesthetist, Certified Registered
4900 BROAD RD
SYRACUSE, NY 13215
Nurse Practitioner (Family)
4900 BROAD RD, SUITE 4K
SYRACUSE, NY 13215
Nurse Anesthetist, Certified Registered
4900 BROAD RD
SYRACUSE, NY 13215
Psychiatry & Neurology (Neurology)
4900 BROAD RD, CGH POB SUITE 2F
SYRACUSE, NY 13215
Physician Assistant
4900 BROAD RD
SYRACUSE, NY 13215

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 Kathleen Ennis's NPI number?

The NPI number for Kathleen Ennis is 1407430341. It was assigned to this individual provider in the NPPES registry on May 6, 2021.

Where is Kathleen Ennis located?

Kathleen Ennis practices at 4900 Broad Rd, Syracuse, NY 13215. The listed phone number is (315) 492-5011.

What is Kathleen Ennis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Kathleen Ennis was last updated on June 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.