Provider Demographics
NPI:1932500204
Name:WILLIS, KARA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:
Last Name:WILLIS
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 1:1905 E 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-1103
Mailing Address - Country:US
Mailing Address - Phone:620-669-0125
Mailing Address - Fax:
Practice Address - Street 1:1905 E 17TH AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-1103
Practice Address - Country:US
Practice Address - Phone:620-669-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-15316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist