Provider Demographics
NPI:1417108143
Name:HAYNES, KARA BETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:BETH
Last Name:HAYNES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 S HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1779
Mailing Address - Country:US
Mailing Address - Phone:606-451-4341
Mailing Address - Fax:606-451-4343
Practice Address - Street 1:181 S HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1779
Practice Address - Country:US
Practice Address - Phone:606-451-4341
Practice Address - Fax:606-451-4343
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19756183500000X
KY0143631835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist