Provider Demographics
NPI:1831814474
Name:KENNEY, KATHRYN ROSE (RPH)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ROSE
Last Name:KENNEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4631 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-8825
Mailing Address - Country:US
Mailing Address - Phone:563-219-2551
Mailing Address - Fax:
Practice Address - Street 1:2255 JOHN F KENNEDY RD STE 16
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-2883
Practice Address - Country:US
Practice Address - Phone:563-219-2551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist