Provider Demographics
NPI:1104242072
Name:KAPSIAK, BARBARA (RPH)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:KAPSIAK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3717 PLUM BLOSSOM CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7051
Mailing Address - Country:US
Mailing Address - Phone:702-243-4789
Mailing Address - Fax:
Practice Address - Street 1:3717 PLUM BLOSSOM CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7051
Practice Address - Country:US
Practice Address - Phone:702-243-4789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY$$$$$$$$$OtherSSN