Healthcare Provider Details

I. General information

NPI: 1508783630
Provider Name (Legal Business Name): KELLY KARST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 SCHWEGLER DR
LAWRENCE KS
66045-7538
US

IV. Provider business mailing address

1200 SCHWEGLER DR
LAWRENCE KS
66045-7538
US

V. Phone/Fax

Practice location:
  • Phone: 785-864-9512
  • Fax:
Mailing address:
  • Phone: 785-864-9512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-107195
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: