Provider Demographics
NPI:1942502182
Name:KLEINSASSER, KAYLEE JO (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:JO
Last Name:KLEINSASSER
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 1:561 HUFFMAN LN
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-4119
Mailing Address - Country:US
Mailing Address - Phone:406-234-2492
Mailing Address - Fax:
Practice Address - Street 1:561 HUFFMAN LN
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-4119
Practice Address - Country:US
Practice Address - Phone:406-234-2492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist