Healthcare Provider Details

I. General information

NPI: 1174315105
Provider Name (Legal Business Name): KYRA LEONARD PHARMD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2025
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5381 S GREEN ST
MURRAY UT
84123-4779
US

IV. Provider business mailing address

4550 KING ST
ALEXANDRIA VA
22302-1307
US

V. Phone/Fax

Practice location:
  • Phone: 800-538-5038
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202222767
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202222767
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: