Provider Demographics
NPI:1417220930
Name:DEPPE, SARA JANE SCHWARTZHOFF (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARA JANE
Middle Name:SCHWARTZHOFF
Last Name:DEPPE
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 1:5501 NW INDIAN HILLS LN
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-3338
Mailing Address - Country:US
Mailing Address - Phone:312-404-2016
Mailing Address - Fax:
Practice Address - Street 1:3515 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2537
Practice Address - Country:US
Practice Address - Phone:816-777-1545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110236861835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist