Provider Demographics
NPI:1700122231
Name:ESTABROOK, KARA LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:LEE
Last Name:ESTABROOK
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 1:4650 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-2964
Mailing Address - Country:US
Mailing Address - Phone:605-760-3386
Mailing Address - Fax:
Practice Address - Street 1:4650 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-2964
Practice Address - Country:US
Practice Address - Phone:605-760-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21786183500000X
SD5961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist