Provider Demographics
NPI:1073636056
Name:HARKEN, BREE KATHLEEN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:BREE
Middle Name:KATHLEEN
Last Name:HARKEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 34TH PL
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-3125
Mailing Address - Country:US
Mailing Address - Phone:515-221-3303
Mailing Address - Fax:
Practice Address - Street 1:3580 EP TRUE PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-7647
Practice Address - Country:US
Practice Address - Phone:515-267-8066
Practice Address - Fax:515-267-1471
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0125344Medicaid
IA0213410088Medicare ID - Type Unspecified