IndividualActive
Kathleen Wise, PHARMD.
NPI 1912923491 · Pharmacotherapy Pharmacist · Broken Arrow, OK
Provider details
- NPI number
- 1912923491
- Entity type
- Individual
- Primary specialty
- Pharmacotherapy PharmacistPharmacy Service Providers
- Credential
- PHARMD.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 13063 (OK)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
3800 W Vicksburg St
Broken Arrow, OK 74011-1362
Phone: (918) 449-8834
Approximate (ZIP-level) locationGet directions
Mailing address
3800 W Vicksburg St
Broken Arrow, OK 74011-1362
Registry dates
- Enumerated
- 2006-07-15
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.