Provider Demographics
NPI:1992211973
Name:THURMAN, KATHRYN BROOKE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:BROOKE
Last Name:THURMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:THURMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2325 CASTLEGATE DR
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:MO
Mailing Address - Zip Code:63052-3829
Mailing Address - Country:US
Mailing Address - Phone:816-738-4230
Mailing Address - Fax:
Practice Address - Street 1:10530 JOHN W ELLIOTT DR STE 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-2014
Practice Address - Country:US
Practice Address - Phone:800-424-9002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017028144183500000X
TX412035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist