Healthcare Provider Details

I. General information

NPI: 1306120506
Provider Name (Legal Business Name): KAREN KAY VANLOENEN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2011
Last Update Date: 10/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9141 S. BROADWAY
HIGHLAND RANCH CO
80126
US

IV. Provider business mailing address

9141 S. BROADWAY
DENVER CO
80126
US

V. Phone/Fax

Practice location:
  • Phone: 720-344-0700
  • Fax:
Mailing address:
  • Phone: 720-344-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10766
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: