Heidi Kennedy, PHARMD
Individual provider Active NPI Pharmacist · Blanding, UT
NPI 1013253350 · NPPES record last updated Dec 13, 2012
Key facts
- NPI
- 1013253350
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5923612-1701 (UT)
- Practice address
- 802 S 200 W
Suite a
Blanding, UT 84511-3910 - Phone
- (435) 678-4690
- NPI assigned
- Dec 13, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5923612-1701 | UT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5923612-1701 | UT | Yes |
Addresses
Primary practice location
802 S 200 W
Suite a
Blanding, UT 84511-3910
Mailing address
390 N 100 W
Blanding, UT 84511-3603
Phone (801) 824-7078
Other providers in Blanding, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.