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General NPI Number Information
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NPI Number | 1700429511
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Entity Type | Individual
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Provider Name | LINDA S KENNY RPH
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Gender | Female
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 2605 BLAIRS FERRY RD NE
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-1802
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Country | US
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Telephone | 319-294-9461
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Fax |
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Provider Business Mailing Address
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Address Line | 10084 SHAW RD
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City | ANAMOSA
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State | IA
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Zip | 52205-7648
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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 | 051.289442
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17424
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License Number State | IA
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