Provider Demographics
NPI:1568743557
Name:KASTENS, LARREE ANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LARREE
Middle Name:ANN
Last Name:KASTENS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5353 YELLOWSTONE RD
Mailing Address - Street 2:ROOM 310
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-4178
Mailing Address - Country:US
Mailing Address - Phone:307-433-3697
Mailing Address - Fax:303-370-1670
Practice Address - Street 1:5353 YELLOWSTONE RD
Practice Address - Street 2:ROOM 310
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4178
Practice Address - Country:US
Practice Address - Phone:307-433-3697
Practice Address - Fax:303-370-1670
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY2676183500000X
CO14112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist