Provider Demographics
NPI:1417438490
Name:MCCANN, KAYLI LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAYLI
Middle Name:LYNN
Last Name:MCCANN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KAYLI
Other - Middle Name:LYNN
Other - Last Name:BUECHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2201 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-4368
Mailing Address - Country:US
Mailing Address - Phone:320-214-8502
Mailing Address - Fax:
Practice Address - Street 1:2201 1ST ST S
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-4209
Practice Address - Country:US
Practice Address - Phone:320-214-8502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN123541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist