Andrea Kaiser
Individual provider Active NPI Pharmacist · Guymon, OK
NPI 1760831663 · NPPES record last updated Jun 10, 2016
Key facts
- NPI
- 1760831663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 15124 (OK)
- Practice address
- 1630 N Lelia St
Guymon, OK 73942-2829 - Phone
- (580) 338-2956
- NPI assigned
- Jun 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 15124 | OK | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15124 | OK | Yes |
Addresses
Primary practice location
1630 N Lelia St
Guymon, OK 73942-2829
Mailing address
1630 N Lelia St
Guymon, OK 73942-2829
Other providers in Guymon, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2016. 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.