Provider Demographics
NPI:1619254257
Name:FANN, SARAH A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:A
Last Name:FANN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:BOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1003 SW ALLENDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2742
Mailing Address - Country:US
Mailing Address - Phone:816-714-4907
Mailing Address - Fax:
Practice Address - Street 1:330 SW WARD RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2445
Practice Address - Country:US
Practice Address - Phone:816-246-7732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005004192183500000X
MO2024000704183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist