Healthcare Provider Details

I. General information

NPI: 1275564676
Provider Name (Legal Business Name): SHARON ANN KENNEDY-NORRIS PHARM.D,, CACP, CGP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 SPRING VALLEY DR
HUNTINGTON WV
25704-9300
US

IV. Provider business mailing address

1780 TOWNSHIP ROAD 116
KITTS HILL OH
45645-8691
US

V. Phone/Fax

Practice location:
  • Phone: 304-429-6755
  • Fax: 304-429-0268
Mailing address:
  • Phone: 740-643-0824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03-3-18596
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number011451
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRP0005902
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: