Provider Demographics
NPI:1255615894
Name:ROYER, KASEY NICOLE-WORM (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:NICOLE-WORM
Last Name:ROYER
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 1:640 SUNBURST HWY
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2546
Mailing Address - Country:US
Mailing Address - Phone:410-901-6290
Mailing Address - Fax:410-901-6295
Practice Address - Street 1:640 SUNBURST HWY
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2546
Practice Address - Country:US
Practice Address - Phone:410-901-6290
Practice Address - Fax:410-901-6295
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18828183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist