Provider Demographics
NPI:1114216397
Name:KENNEDY, JULIA ELAINE (PHARMD, RPH)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ELAINE
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 NEW HARTFORD RD
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1311
Mailing Address - Country:US
Mailing Address - Phone:270-684-0205
Mailing Address - Fax:270-685-0754
Practice Address - Street 1:2440 NEW HARTFORD RD
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1311
Practice Address - Country:US
Practice Address - Phone:270-684-0205
Practice Address - Fax:270-685-0754
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist