Provider Demographics
NPI:1235861899
Name:PARDY, KAYLA (PHD)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:PARDY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 W CEDAR ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BERESFORD
Mailing Address - State:SD
Mailing Address - Zip Code:57004-1608
Mailing Address - Country:US
Mailing Address - Phone:605-763-2633
Mailing Address - Fax:
Practice Address - Street 1:911 W CEDAR ST STE 1
Practice Address - Street 2:
Practice Address - City:BERESFORD
Practice Address - State:SD
Practice Address - Zip Code:57004-1608
Practice Address - Country:US
Practice Address - Phone:605-763-2633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6950183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6950OtherSD BOARD OF PHARMACY