Healthcare Provider Details

I. General information

NPI: 1962318329
Provider Name (Legal Business Name): DEVYN LACROIX
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11124 HOLMES RD
KANSAS CITY MO
64131-3625
US

IV. Provider business mailing address

9001 METCALF AVE APT 4022
OVERLAND PARK KS
66212-2691
US

V. Phone/Fax

Practice location:
  • Phone: 816-942-3262
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2026040893
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: