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General NPI Number Information
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NPI Number | 1811321839
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Entity Type | Individual
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Provider Name | JODIE FAYE KENNEDY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 1 CAMERON HILL CIR
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City | CHATTANOOGA
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State | TN
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Zip | 37402-9815
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Country | US
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Telephone | 423-535-4593
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Fax |
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Provider Business Mailing Address
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Address Line | 146 COMPTON ST
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City | GALLATIN
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State | TN
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Zip | 37066-1478
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Country | US
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Telephone | 615-210-4100
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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 | 37559
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License Number State | TN
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