Provider Demographics
NPI:1114204799
Name:ROBISON, KASI (RPH)
Entity Type:Individual
Prefix:
First Name:KASI
Middle Name:
Last Name:ROBISON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 17TH ST
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-4701
Mailing Address - Country:US
Mailing Address - Phone:307-527-7426
Mailing Address - Fax:307-527-7435
Practice Address - Street 1:1825 17TH ST
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-4701
Practice Address - Country:US
Practice Address - Phone:307-527-7426
Practice Address - Fax:307-527-7435
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY2731183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist