Wall, Kathy
Wall, Kathy is an individual health care provider with primary practice located at 340 Kelley Pkwy Ste D , Mexico MO 65265-3811. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Wall, Kathy can be contacted via phone (573) 567-7077.Contact Information
Primary practice address
340 Kelley Pkwy Ste D
Mexico MO 65265-3811
Phone: (573) 567-7077
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 040528 | Missouri |
Profile Details
| NPI number | 1306364708 |
|---|---|
| LBN Legal business name | Wall, Kathy |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2017 |
| Last updated | Jul 21st, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306364708 | NPPES |
| Missouri | Other | 040528 | PHARMACIST LICENSE |
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