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General NPI Number Information
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NPI Number | 1962958637
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Entity Type | Individual
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Provider Name | KENNETH R CARNES PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 08/31/2016
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Last Update Date | 08/31/2016
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Provider Practice Location Address
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Address Line | 4400 E 2ND ST
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City | CASPER
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State | WY
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Zip | 82609-4215
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Country | US
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Telephone | 307-237-0994
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Fax | 307-237-1487
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Provider Business Mailing Address
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Address Line | PO BOX 880
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City | GLENROCK
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State | WY
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Zip | 82637-0880
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Country | US
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Telephone |
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Fax |
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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 | 1884
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License Number State | WY
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