Provider Demographics
NPI:1285239350
Name:CARVELL, KAITLYN (PHARM D)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:CARVELL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6140 GREEN HILLS LN
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2508
Mailing Address - Country:US
Mailing Address - Phone:816-244-1322
Mailing Address - Fax:
Practice Address - Street 1:201 N BELT HWY
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3451
Practice Address - Country:US
Practice Address - Phone:816-232-9011
Practice Address - Fax:816-232-3488
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-105988183500000X
MO2018021536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist