Provider Demographics
NPI:1629314505
Name:DURHAM, ANNE L (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:L
Last Name:DURHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 WALNUT ST UNIT 2003
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106-4214
Mailing Address - Country:US
Mailing Address - Phone:913-638-1766
Mailing Address - Fax:
Practice Address - Street 1:4820 N OAK TRFY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4691
Practice Address - Country:US
Practice Address - Phone:816-452-8845
Practice Address - Fax:816-452-6794
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001028217183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist