Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kennede Marissa Wallace, PHARMD

Individual provider Pharmacist · NPI 1033971197

Kennede Marissa Wallace, PHARMD is a Pharmacist in Charleston, South Carolina. Practices as a sole proprietor. Licensed in South Carolina.

Licensed in
SC
In the registry since
2024
What do these letters mean?
PHARMD — Doctor of Pharmacy
The professional degree required to practise as a pharmacist in the United States.

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Practice location Address checks out

51 Nassau St
Charleston, SC 29403-5513
Phone: (843) 486-2084
Fax: (843) 486-2084
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 44219 (SC)

Record details

NPI number1033971197
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHARMD
Sole proprietorYes
NPI enumeratedJanuary 24, 2024
Last updated in NPPESJanuary 24, 2024
Certification dateJanuary 24, 2024

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