Provider Demographics
NPI:1316362379
Name:BROPHY, KARA
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:BROPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6435 ALIANTE PKWY
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-3196
Mailing Address - Country:US
Mailing Address - Phone:702-657-1163
Mailing Address - Fax:702-657-8466
Practice Address - Street 1:6435 ALIANTE PKWY
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-3196
Practice Address - Country:US
Practice Address - Phone:702-657-1163
Practice Address - Fax:702-657-8466
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13716183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist