Provider Demographics
NPI:1205833720
Name:KAYDEN, COLEEN MARY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:COLEEN
Middle Name:MARY
Last Name:KAYDEN
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 1:1109 LETORT RD
Mailing Address - Street 2:
Mailing Address - City:CONESTOGA
Mailing Address - State:PA
Mailing Address - Zip Code:17516-9311
Mailing Address - Country:US
Mailing Address - Phone:717-872-9267
Mailing Address - Fax:
Practice Address - Street 1:205 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2705
Practice Address - Country:US
Practice Address - Phone:717-393-3814
Practice Address - Fax:717-393-7537
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030192L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist