Provider Demographics
NPI:1275512428
Name:CROUSE, KARYN JANELLE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KARYN
Middle Name:JANELLE
Last Name:CROUSE
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 1:4020 PLACID DR
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-5016
Mailing Address - Country:US
Mailing Address - Phone:307-473-3017
Mailing Address - Fax:
Practice Address - Street 1:2546 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-2047
Practice Address - Country:US
Practice Address - Phone:307-472-0597
Practice Address - Fax:307-237-7731
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY2636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist