Provider Demographics
NPI:1467525451
Name:KREIS, KARA JOAN (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:JOAN
Last Name:KREIS
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 1:19494 STOR ST
Mailing Address - Street 2:
Mailing Address - City:BRADY
Mailing Address - State:NE
Mailing Address - Zip Code:69123-2997
Mailing Address - Country:US
Mailing Address - Phone:308-584-2398
Mailing Address - Fax:
Practice Address - Street 1:810 W REID AVE
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6583
Practice Address - Country:US
Practice Address - Phone:308-534-8886
Practice Address - Fax:308-534-7825
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist