Provider Demographics
NPI:1881916492
Name:KROHN, MICHAEL DUANE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DUANE
Last Name:KROHN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 S RACETRACK RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-8539
Mailing Address - Country:US
Mailing Address - Phone:702-565-7446
Mailing Address - Fax:702-564-4041
Practice Address - Street 1:732 SOUTH RACETRACK ROAD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-8539
Practice Address - Country:US
Practice Address - Phone:702-565-7446
Practice Address - Fax:702-564-4041
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14967183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist