Provider Demographics
NPI:1346607199
Name:BURFORD, KELSEY SUZANNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:SUZANNE
Last Name:BURFORD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:SUZANNE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 N 270TH ST
Mailing Address - Street 2:
Mailing Address - City:MULBERRY
Mailing Address - State:KS
Mailing Address - Zip Code:66756-4168
Mailing Address - Country:US
Mailing Address - Phone:620-423-7480
Mailing Address - Fax:620-308-7109
Practice Address - Street 1:1011 E CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6603
Practice Address - Country:US
Practice Address - Phone:620-308-7110
Practice Address - Fax:620-308-7109
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-112226183500000X
MO2012023887183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist