Provider Demographics
NPI:1982200564
Name:TAYLOR, KENA DANIELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KENA
Middle Name:DANIELLE
Last Name:TAYLOR
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 1:2007 W BEEBE CAPPS EXPY
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-5014
Mailing Address - Country:US
Mailing Address - Phone:501-305-1000
Mailing Address - Fax:501-305-1002
Practice Address - Street 1:2007 W BEEBE CAPPS EXPY
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-5014
Practice Address - Country:US
Practice Address - Phone:501-305-1000
Practice Address - Fax:501-305-1002
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist