Healthcare Provider Details

I. General information

NPI: 1982202354
Provider Name (Legal Business Name): BRETT M KAPPELMANN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 10/16/2020
Certification Date: 10/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 STATE ST
AUGUSTA KS
67010-1107
US

IV. Provider business mailing address

30 N SAGEBRUSH CIR
WICHITA KS
67230-6634
US

V. Phone/Fax

Practice location:
  • Phone: 316-775-2289
  • Fax: 316-775-2280
Mailing address:
  • Phone: 316-775-5480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-13472
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: