KAYLYN CASEBOLT DESROSIER (NPI# 1346880119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346880119 |
| Entity Type | Individual |
| Full Name | KAYLYN CASEBOLT DESROSIER |
| Credential | PHARMD |
| Practice Address |
500 W Broadway St Missoula MT 59802-4008 |
| Mailing Address |
11892 Okeefe Creek Blvd Missoula MT 59808-8514 |
| Practice Telephone | 4063271650 |
| Mailing Telephone | 4065798493 |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2020-01-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PHA-PHA-LIC-3944 | MT | Pharmacy Service Providers |
| Street Address |
500 W BROADWAY ST |
| City | MISSOULA |
| State | MT |
| Zip Code | 59802-4008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982600359 | Kendra B. Lee | Family Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2005-06-21 |
| 1205468725 | Stephanie Elizabeth Carl | Physician Assistant | 500 W Broadway St, Missoula, MT 59802-4008 | 2020-02-12 |
| 1942840483 | Credena Health LLC | Durable Medical Equipment & Medical Supplies | 500 W Broadway St, Missoula, MT 59802-4008 | 2020-01-13 |
| 1689168049 | Kacia Bundle | Nurse Practitioner | 500 W Broadway St, Missoula, MT 59802-4008 | 2018-06-19 |
| 1114424488 | Hannah Gilliland | Nurse Practitioner | 500 W Broadway St, Missoula, MT 59802-4008 | 2018-04-12 |
| 1386164408 | Sandra Lynn Cummins | Social Worker | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-06-20 |
| 1548797152 | Joseph M Miller | Internal Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-05-12 |
| 1083147664 | Matthew Mcgady | Physician Assistant | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-04-10 |
| 1982135216 | Meeka Pradeep Gandhi | Pediatrics | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-03-27 |
| 1033640370 | Abigail Rose Mansch | Internal Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-03-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945921 | Montana Endoscopy Center, Pllc | Clinic/Center | 1930 W Broadway, Ste B, Missoula, MT 59802 | 2020-06-08 |
| 1194364091 | Tommie Lynn Perusich | Nurse Practitioner | 1120 Cedar St., Missoula, MT 59802 | 2019-12-26 |
| 1386122752 | The Hope Health Alliance, Inc. | Case Management | 314 White House Ln, Missoula, MT 59802 | 2018-07-30 |
| 1881181444 | Carol Anne Lesser | Massage Therapist | 1918 Birch St, Missoula, MT 59802 | 2018-04-19 |
| 1528587581 | Missoula Aids Fund, Inc. | Clinic/Center | 1500 W. Broadway Suite A, Missoula, MT 59802 | 2017-09-11 |
| 1942740667 | Gabrielle Shulman | Counselor | 415 N Higgins Ave Ste 14, Missoula, MT 59802 | 2017-02-28 |
| 1053798736 | Endurance Physio | Clinic/Center | 214 E. Main St, Missoula, MT 59802 | 2015-05-01 |
| 1720481971 | Anna Golding | Counselor | 1325 Wyoming Street, Missoula, MONTANA 59802 | 2014-10-02 |
| 1003255803 | Jennifer Dawn Danielson | Speech-Language Pathologist | 2408 Duncan Drive, Missoula, MT 59802 | 2013-06-14 |
| 1437595725 | Partnership Health Center Inc | Clinic/Center | 1150 Sherwood St, Missoula, MT 59802 | 2013-05-14 |
| Find all providers in zip 59802 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104435916 | Christopher Ludwig | Pharmacist | 4011 Melrose Pl, Missoula, MT 59808-5890 | 2020-07-28 |
| 1053973701 | Alexander Vladimirovich Chinikaylo | Pharmacist | 10878 Peaks Row Ln, Missoula, MT 59808-8478 | 2019-07-02 |
| 1912466202 | Jenner Minto | Pharmacist | University of Montana 317 Skaggs Building, Missoula, MT 59812-0001 | 2019-03-15 |
| 1861873515 | Kylie Rauch | Pharmacist | 1821 South Ave W Ste 101, Missoula, MT 59801-6518 | 2015-06-17 |
| 1164827929 | Charles Ellis | Pharmacist | 534 S 5th St W, Missoula, MT 59801-2618 | 2014-10-22 |
| 1467860353 | Zachary Ueland | Pharmacist | 4000 Highway 93 South, Missoula, MT 59804 | 2014-07-24 |
| 1649600719 | Kimberlee Becker | Pharmacist | 5255 Elk Ridge Rd, Missoula, MT 59802-5227 | 2013-11-26 |
| 1982043956 | Sadie Linford | Pharmacist | 1914 Brooks St, Missoula, MT 59801-6644 | 2013-06-22 |
| 1972870160 | Lee Ann Peterson | Pharmacist | 619 Dixon Ave, Missoula, MT 59801-8623 | 2011-11-16 |
| 1639454127 | Dentyn Dunaway | Pharmacist | 2527 N Reserve Street, Missoula, MT 59808 | 2011-10-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.