Provider Demographics
NPI:1619198108
Name:TERRY, MONICA V (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:V
Last Name:TERRY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11816 JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-2650
Mailing Address - Country:US
Mailing Address - Phone:913-596-4651
Mailing Address - Fax:913-596-4636
Practice Address - Street 1:8919 PARALLEL PKWY
Practice Address - Street 2:WEST TOWER, SUITE 403
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1636
Practice Address - Country:US
Practice Address - Phone:913-596-4651
Practice Address - Fax:913-596-4636
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12402183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist