Provider Demographics
NPI:1932758414
Name:KITTLE, JANNA MICHELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:MICHELLE
Last Name:KITTLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JANNA
Other - Middle Name:MICHELLE
Other - Last Name:CRUMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8823 NE PAW PAW DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64157-8232
Mailing Address - Country:US
Mailing Address - Phone:307-421-5520
Mailing Address - Fax:
Practice Address - Street 1:2800 CLAY EDWARDS DR
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3220
Practice Address - Country:US
Practice Address - Phone:816-691-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-08
Last Update Date:2019-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130327971835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy