Provider Demographics
NPI:1487354387
Name:SECORD, KARI LYNN (PHARMACY TECHNITION)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:LYNN
Last Name:SECORD
Suffix:
Gender:F
Credentials:PHARMACY TECHNITION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9392 DODGE RD APT 1
Mailing Address - Street 2:
Mailing Address - City:OTISVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48463-8429
Mailing Address - Country:US
Mailing Address - Phone:707-338-0933
Mailing Address - Fax:
Practice Address - Street 1:4515 E MOUNT MORRIS RD
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:MI
Practice Address - Zip Code:48458-8737
Practice Address - Country:US
Practice Address - Phone:810-640-2110
Practice Address - Fax:810-640-1560
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303017765183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician