Provider Demographics
NPI:1295722197
Name:GURNEY, MARY KATHLEEN (RPH, PHD)
Entity type:Individual
Prefix:PROF
First Name:MARY
Middle Name:KATHLEEN
Last Name:GURNEY
Suffix:
Gender:F
Credentials:RPH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19555 N 59TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6813
Mailing Address - Country:US
Mailing Address - Phone:623-572-3525
Mailing Address - Fax:623-572-3550
Practice Address - Street 1:MIDWESTERN UNIVERSITY
Practice Address - Street 2:19555 N 59TH AVENUE
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:623-572-3525
Practice Address - Fax:623-572-3550
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016161A183500000X
AZS019097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS019097OtherARIZONA BOARD OF PHARMACY
IN26016161AOtherSTATE PHARMACY LICENSE