Provider Demographics
NPI:1922383751
Name:KENNEDY, CINDY SUTTON (RPH)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:SUTTON
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 HIGHLAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-7109
Mailing Address - Country:US
Mailing Address - Phone:336-718-6199
Mailing Address - Fax:336-718-6109
Practice Address - Street 1:200 HAWTHORNE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2515
Practice Address - Country:US
Practice Address - Phone:704-316-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6893183500000X
TN28084183500000X
NC99451835C0206X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835C0206XPharmacy Service ProvidersPharmacistCardiology