Provider Demographics
NPI:1427674936
Name:MCKEAN, JANICE ANNE (PHARM D)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:ANNE
Last Name:MCKEAN
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 1:2003 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BEEBE
Mailing Address - State:AR
Mailing Address - Zip Code:72012-2544
Mailing Address - Country:US
Mailing Address - Phone:316-680-1826
Mailing Address - Fax:
Practice Address - Street 1:2003 W CENTER ST
Practice Address - Street 2:
Practice Address - City:BEEBE
Practice Address - State:AR
Practice Address - Zip Code:72012-2544
Practice Address - Country:US
Practice Address - Phone:501-882-1516
Practice Address - Fax:501-882-1530
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-20
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist