Provider Demographics
NPI:1184940603
Name:SPRINKLE, LAURA R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:R
Last Name:SPRINKLE
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 1:10701 W 128TH PL
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4517
Mailing Address - Country:US
Mailing Address - Phone:913-685-0996
Mailing Address - Fax:913-685-3623
Practice Address - Street 1:10701 W 128TH PL
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-4517
Practice Address - Country:US
Practice Address - Phone:913-685-0996
Practice Address - Fax:913-685-3623
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-11913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1-11913OtherPHARMACY LICENSE