Provider Demographics
NPI:1558034397
Name:HEUSDENS, KASEY (PHARM D)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:HEUSDENS
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 1:3297 W UPPER HUNTLY WAY
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-2525
Mailing Address - Country:US
Mailing Address - Phone:720-290-1668
Mailing Address - Fax:
Practice Address - Street 1:7859 S 3200 W
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-5230
Practice Address - Country:US
Practice Address - Phone:801-255-7557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10960949-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist