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General NPI Number Information
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NPI Number | 1861785164
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Entity Type | Individual
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Provider Name | SHIRLEY KAYE KENNEDY-BRYANT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 05/18/2011
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Provider Practice Location Address
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Address Line | 1401 KEENE RD
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City | NICHOLASVILLE
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State | KY
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Zip | 40356-8922
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Country | US
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Telephone | 859-881-3682
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Fax |
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Provider Business Mailing Address
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Address Line | 1436 ELMFORK RD
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City | NICHOLASVILLE
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State | KY
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Zip | 40356-9675
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Country | US
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Telephone | 859-967-9226
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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 | 015158
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License Number State | KY
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