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Individual

DR. KENNETH JAQUEZ RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(980) 488-5336
(704) 316-2270
Mailing address
2010 N BREVARD ST APT 635, CHARLOTTE, NC 28206-3948
(706) 951-4813
(704) 316-2270

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
700651
NC
1835P2201X
Ambulatory Care Pharmacist
34259
NC

Other

Enumeration date
06/07/2021
Last updated
12/03/2025
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