Provider Demographics
NPI:1114476348
Name:HARPER, MARIE JOLENE (RPH)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:JOLENE
Last Name:HARPER
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 1:5500 E HARRY ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-3826
Mailing Address - Country:US
Mailing Address - Phone:316-686-9200
Mailing Address - Fax:316-251-2787
Practice Address - Street 1:5500 E HARRY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-3826
Practice Address - Country:US
Practice Address - Phone:316-686-9200
Practice Address - Fax:316-251-2787
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-10767183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist