Provider Demographics
NPI:1073953113
Name:GUTHRIE, KENDALL DANAE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:DANAE
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:DANAE
Other - Last Name:SHACKLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2464 CHARLOTTE STREET
Mailing Address - Street 2:HSB 3244
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108
Mailing Address - Country:US
Mailing Address - Phone:816-235-1709
Mailing Address - Fax:
Practice Address - Street 1:2800 CLAY EDWARDS DR
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116
Practice Address - Country:US
Practice Address - Phone:816-346-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013022793183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist