=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699087155
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HOLLY SHARZAD SKELTON PHARM D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/12/2010
-----------------------------------------------------
Last Update Date | 03/30/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1000 CARONDELET DR SUITE 120
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64114-4673
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-943-4879
-----------------------------------------------------
Fax | 816-943-4882
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 255 NW VICTORIA DR
-----------------------------------------------------
City | LEES SUMMIT
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64086-4709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-875-5111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 2010023011
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------