Travis Lynn Cleffman, PHARMD
Individual provider Active NPI Pharmacist · Mulberry, KS
NPI 1821731563 · NPPES record last updated Apr 20, 2022
Key facts
- NPI
- 1821731563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 1-109709 (KS)
- Practice address
- 1195 E 610TH Ave
Mulberry, KS 66756-4083 - Phone
- (620) 249-8357
- NPI assigned
- Apr 20, 2022
- Sex
- Male
- 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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-109709 | KS | MD | Pharmacist |
| 2020005564 | MO | MD | Pharmacist |
| 18725 | OK | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18725 | OK | |
| Pharmacist | 183500000X | 2020005564 | MO | |
| Pharmacist | 183500000X | 1-109709 | KS | Yes |
Addresses
Primary practice location
1195 E 610TH Ave
Mulberry, KS 66756-4083
Mailing address
1195 E 610TH Ave
Mulberry, KS 66756-4083
Phone (620) 249-8357
Other providers in Mulberry, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2022. 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.