Kimberly Dawn Fox
Individual provider Active NPI Pharmacist · Keokuk, IA
NPI 1639708167 · NPPES record last updated Apr 6, 2020
Key facts
- NPI
- 1639708167
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 17578 (IA)
- Practice address
- 3111 Main St
Keokuk, IA 52632-2231 - Phone
- (319) 524-9535
- NPI assigned
- Apr 6, 2020
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17578 | IA | MD | Pharmacist |
| 286282 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 286282 | IL | |
| Pharmacist | 183500000X | 17578 | IA | Yes |
Addresses
Primary practice location
3111 Main St
Keokuk, IA 52632-2231
Mailing address
3111 Main St
Keokuk, IA 52632-2231
Phone (319) 524-9535
Other providers in Keokuk, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2020. 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.