Healthcare Provider Details

I. General information

NPI: 1134821564
Provider Name (Legal Business Name): KERRI PATTERSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERRI FOX

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9211 E 21ST ST N
WICHITA KS
67206-2900
US

IV. Provider business mailing address

5777 E BRISTOL ST
BEL AIRE KS
67220-1302
US

V. Phone/Fax

Practice location:
  • Phone: 316-609-4501
  • Fax:
Mailing address:
  • Phone: 636-485-7136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number1-117882
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: