Healthcare Provider Details

I. General information

NPI: 1013831734
Provider Name (Legal Business Name): KESLEY SARBAUGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 N JEFFERSON ST
CARROLLTON MO
64633-1945
US

IV. Provider business mailing address

607 N MAIN ST
CARROLLTON MO
64633-1721
US

V. Phone/Fax

Practice location:
  • Phone: 660-322-1783
  • Fax:
Mailing address:
  • Phone: 660-322-1783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2026036404
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: