Provider Demographics
NPI:1487627659
Name:WRIGHT, KAYE LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:KAYE
Middle Name:LYNN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BECKY CT
Mailing Address - Street 2:
Mailing Address - City:COAL VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61240-9647
Mailing Address - Country:US
Mailing Address - Phone:309-234-5209
Mailing Address - Fax:
Practice Address - Street 1:129 W LOCUST ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-2803
Practice Address - Country:US
Practice Address - Phone:563-324-1641
Practice Address - Fax:563-884-4480
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA15700183500000X
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist