Provider Demographics
NPI:1205365244
Name:KINDOPP, KAY LEIGH (RPH)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:LEIGH
Last Name:KINDOPP
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 1:3906 N 195TH ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-5224
Mailing Address - Country:US
Mailing Address - Phone:402-650-9892
Mailing Address - Fax:
Practice Address - Street 1:2301 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1124
Practice Address - Country:US
Practice Address - Phone:402-817-0165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-04
Last Update Date:2017-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13927183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist