Provider Demographics
NPI:1144653304
Name:MCCARTNEY, KYLE R (PHARMD)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:R
Last Name:MCCARTNEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-3304
Mailing Address - Country:US
Mailing Address - Phone:308-384-2626
Mailing Address - Fax:
Practice Address - Street 1:1230 N WEBB RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3304
Practice Address - Country:US
Practice Address - Phone:308-384-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist