MEDICARE: MRS. LAUREN PARDUE KENNEDY PHARM. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	22173	LA

General Provider Information

NPI Number	:	1538687173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAUREN PARDUE KENNEDY PHARM. D.

Provider Business Mailing Address
First Line	:	1806 FOURTH ST
Second Line	:
City	:	JONESVILLE
State	:	LA
Zip	:	71343-2002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1806 FOURTH ST
Second Line	:
City	:	JONESVILLE
State	:	LA
Zip	:	71343-2002
Country	:	US
Telephone Number	:	318-339-8532
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2017
Last Update Date	:	08/26/2022

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