Provider Demographics
NPI:1750989455
Name:KYLE, AMBER (PHARMD, BCCCP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:KYLE
Suffix:
Gender:F
Credentials:PHARMD, BCCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7930 MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1562
Mailing Address - Country:US
Mailing Address - Phone:866-451-8804
Mailing Address - Fax:913-451-8914
Practice Address - Street 1:7930 MARSHALL DR
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-1562
Practice Address - Country:US
Practice Address - Phone:866-451-8804
Practice Address - Fax:913-451-8914
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14794183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist