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General NPI Number Information
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NPI Number | 1396563748
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Entity Type | Individual
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Provider Name | KAMILA LEA CROUSE PHARM .D.
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Gender | Female
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 2907 HWY 65-82 SOUTH
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City | LAKE VILLAGE
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State | AR
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Zip | 71653
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Country | US
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Telephone | 870-265-5555
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Fax | 870-265-3174
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Provider Business Mailing Address
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Address Line | P.O. BOX 548
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City | LAKE VILLAGE
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State | AR
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Zip | 71653
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Country | US
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Telephone | 870-265-5555
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Fax | 870-265-3174
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PD11102
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License Number State | AR
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