Provider Demographics
NPI:1386732212
Name:BUTCHER, KAYLEEN A (RPH)
Entity type:Individual
Prefix:
First Name:KAYLEEN
Middle Name:A
Last Name:BUTCHER
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 1:800 FIELD ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-5423
Mailing Address - Country:US
Mailing Address - Phone:303-202-0442
Mailing Address - Fax:
Practice Address - Street 1:800 FIELD ST.
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-5423
Practice Address - Country:US
Practice Address - Phone:303-202-0442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist