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General NPI Number Information
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NPI Number | 1497145346
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Entity Type | Individual
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Provider Name | NATHAN KENNEDY
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Gender | Male
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 1222 S PATTERSON BLVD STE 110
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City | DAYTON
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State | OH
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Zip | 45402-2643
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Country | US
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Telephone | 937-424-1440
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Fax |
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Provider Business Mailing Address
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Address Line | 213 HOWARD ST
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City | WAVERLY
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State | NY
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Zip | 14892-1519
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP449125
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License Number State | PA
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