Provider Demographics
NPI:1073097200
Name:BERNING, KAYLEIGH JO (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:JO
Last Name:BERNING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KAYLEIGH
Other - Middle Name:JO
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:LEOTI
Mailing Address - State:KS
Mailing Address - Zip Code:67861-0042
Mailing Address - Country:US
Mailing Address - Phone:785-871-0933
Mailing Address - Fax:
Practice Address - Street 1:219 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ULYSSES
Practice Address - State:KS
Practice Address - Zip Code:67880-2130
Practice Address - Country:US
Practice Address - Phone:620-356-1446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-15839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist