Provider Demographics
NPI:1093725350
Name:ANNA, KAVITHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAVITHA
Middle Name:
Last Name:ANNA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KAVITHA
Other - Middle Name:
Other - Last Name:MAKAYEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:223 77TH PL
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-2651
Mailing Address - Country:US
Mailing Address - Phone:515-309-2177
Mailing Address - Fax:
Practice Address - Street 1:3600 30TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5753
Practice Address - Country:US
Practice Address - Phone:515-699-5999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL51289194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist