Provider Demographics
NPI:1669848859
Name:FANG, FLORENCE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:FLORENCE
Middle Name:
Last Name:FANG
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 1:10014 W 118TH TER
Mailing Address - Street 2:# 4
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-3100
Mailing Address - Country:US
Mailing Address - Phone:612-987-3846
Mailing Address - Fax:
Practice Address - Street 1:12801 KANSAS AVE
Practice Address - Street 2:
Practice Address - City:BONNER SPRINGS
Practice Address - State:KS
Practice Address - Zip Code:66012-9202
Practice Address - Country:US
Practice Address - Phone:913-441-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14358183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist