Provider Demographics
NPI:1871900738
Name:GLEASON, TAMMY (PHARMD)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:GLEASON
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 1:5311 SW 22ND PL
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-1500
Mailing Address - Country:US
Mailing Address - Phone:785-228-8762
Mailing Address - Fax:785-228-8764
Practice Address - Street 1:5311 SW 22ND PL
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-1500
Practice Address - Country:US
Practice Address - Phone:785-228-8762
Practice Address - Fax:785-228-8764
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-11
Last Update Date:2020-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14345183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist