Provider Demographics
NPI:1891027652
Name:KENNADAY, SELENA A (PHARM D)
Entity type:Individual
Prefix:MS
First Name:SELENA
Middle Name:A
Last Name:KENNADAY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 PARKWAY VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-6857
Mailing Address - Country:US
Mailing Address - Phone:336-771-9711
Mailing Address - Fax:336-771-9710
Practice Address - Street 1:420 FUN CENTER DRIVE
Practice Address - Street 2:WALMART PHARMACY
Practice Address - City:SURF CITY
Practice Address - State:NC
Practice Address - Zip Code:28445
Practice Address - Country:US
Practice Address - Phone:910-803-6003
Practice Address - Fax:910-803-6004
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21304183500000X
NY053530183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist