Healthcare Provider Details

I. General information

NPI: 1356821474
Provider Name (Legal Business Name): KARA SHAWNTEL YEAGER PHARMD, R.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 FRANKLIN DR
CRETE NE
68333-2556
US

IV. Provider business mailing address

555 FRANKLIN DR
CRETE NE
68333-2556
US

V. Phone/Fax

Practice location:
  • Phone: 402-418-1867
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11891
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: