Provider Demographics
NPI:1215114335
Name:KENNY, KATHLEEN S (RPH, PHARMD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:S
Last Name:KENNY
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:MRS
Other - First Name:KATHLEEN
Other - Middle Name:LOUISE
Other - Last Name:SCHIFRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:3250 CENTENNIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4077
Mailing Address - Country:US
Mailing Address - Phone:719-866-6646
Mailing Address - Fax:
Practice Address - Street 1:3250 CENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4077
Practice Address - Country:US
Practice Address - Phone:719-866-6646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist