Individual
NICOLE ELIZABETH KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
343 PINEWOOD RD, SUMTER, SC 29150-5442
(803) 305-6237
Mailing address
345 EDENWOOD DR, SUMTER, SC 29154-8141
(803) 464-2050
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
37399
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427569987
NPI
SC
01
—
37399
SC PHARMACY LICENSE
SC
Enumeration date
10/23/2017
Last updated
05/05/2019
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