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General NPI Number Information
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NPI Number | 1699749812
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Entity Type | Individual
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Provider Name | MARK CHRISTOPHER KENNY RP
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Gender | Male
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 810 W REID AVE
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6583
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Country | US
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Telephone | 308-534-8886
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Fax | 308-534-7825
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Provider Business Mailing Address
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Address Line | 2600 CEDARBERRY RD
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5839
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Country | US
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Telephone | 308-534-6222
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Fax | 308-534-7825
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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 | 9122
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License Number State | NE
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