Provider Demographics
NPI:1497740559
Name:BOND, KAREN SUE (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:BOND
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 1:10 HEADLEY LN
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-6335
Mailing Address - Country:US
Mailing Address - Phone:479-855-3001
Mailing Address - Fax:
Practice Address - Street 1:1 MERCY WAY
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72714-3000
Practice Address - Country:US
Practice Address - Phone:479-876-6200
Practice Address - Fax:479-876-2232
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-288245183500000X
IN26016372A183500000X
AR9238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26016372AOtherLICENSE NUMBER
ARPD09238OtherLICENSE NUMBER