1417992496 NPI number — MS. KATHLEEN ANNE SNELLA PHARMD

Table of content: DANIEL HUERTA (NPI 1033795570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417992496 NPI number — MS. KATHLEEN ANNE SNELLA PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SNELLA
Provider First Name:
KATHLEEN
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417992496
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1804 LONGSTREET DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65202-3396
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-529-6423
Provider Business Mailing Address Fax Number:
573-884-2166

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UMKC SCHOOL OF PHARMACY - SATELLITE PROGRAM
Provider Second Line Business Practice Location Address:
831 LEWIS HALL; UNIVERSITY OF MISSOURI
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65211-4530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-882-1590
Provider Business Practice Location Address Fax Number:
573-884-2166
Provider Enumeration Date:
06/16/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  042923 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 183500000X , with the licence number: 32571 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1835P1200X , with the licence number: 042923 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1835P1200X , with the licence number: 32571 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)