Provider Demographics
NPI:1417230145
Name:SONNENFELD, KANDICE (PHARM D)
Entity Type:Individual
Prefix:
First Name:KANDICE
Middle Name:
Last Name:SONNENFELD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 NW 55TH PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7723
Mailing Address - Country:US
Mailing Address - Phone:405-410-4293
Mailing Address - Fax:
Practice Address - Street 1:301 S SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-6329
Practice Address - Country:US
Practice Address - Phone:405-330-6093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist