Provider Demographics
NPI:1487486833
Name:KNUPPEL, KAYLEE LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:LYNN
Last Name:KNUPPEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KAYLEE
Other - Middle Name:LYNN
Other - Last Name:DUFRENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:568 WILLOWRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-3227
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1405 JEFFERSON HWY STE A
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2448
Practice Address - Country:US
Practice Address - Phone:504-842-7439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.025459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist