Provider Demographics
NPI:1093471013
Name:NEAL, KENNEDY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KENNEDY
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SWIFTON
Mailing Address - State:AR
Mailing Address - Zip Code:72471-8808
Mailing Address - Country:US
Mailing Address - Phone:870-217-9443
Mailing Address - Fax:
Practice Address - Street 1:411 MAIN ST
Practice Address - Street 2:
Practice Address - City:SWIFTON
Practice Address - State:AR
Practice Address - Zip Code:72471-8808
Practice Address - Country:US
Practice Address - Phone:870-217-9443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-14
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist