Provider Demographics
NPI:1932811759
Name:KANN, ASHLEY RAE (PHARMD, BCCCP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RAE
Last Name:KANN
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 1:216 S COUNTRY CLUB AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:SD
Mailing Address - Zip Code:57005-6614
Mailing Address - Country:US
Mailing Address - Phone:701-715-0533
Mailing Address - Fax:
Practice Address - Street 1:216 S COUNTRY CLUB AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:SD
Practice Address - Zip Code:57005-6614
Practice Address - Country:US
Practice Address - Phone:701-715-0533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD62561835C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical Care