Healthcare Provider Details

I. General information

NPI: 1275976466
Provider Name (Legal Business Name): REANNON KAUP PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8031 WADSWORTH BLVD
ARVADA CO
80003-1645
US

IV. Provider business mailing address

8031 WADSWORTH BLVD
ARVADA CO
80003-1645
US

V. Phone/Fax

Practice location:
  • Phone: 303-420-1377
  • Fax: 303-431-5313
Mailing address:
  • Phone: 303-420-1377
  • Fax: 303-431-5313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number17745
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: