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MRS. KIMBERLY DAWN PUCKETT PHARMD
NPI 1700210085
Pharmacist in Ponderay, ID

Active since August 22, 2013
212 BONNER MALL WAY, PONDERAY, ID 83852(208) 255-8066(208) 263-6623 Get Directions Write a Review

NPPES record last updated: August 22, 2013. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Mrs. Kimberly Dawn Puckett Pharmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KIMBERLY DAWN PUCKETT PHARMD (NPI 1700210085) is an individual pharmacist in Ponderay, Idaho, licensed in Idaho (P5173) and active in the NPI registry since August 2013.

NPPES Registry Identity

NPI1700210085
Entity TypeIndividualFemale
Primary Taxonomy183500000X
Provider Legal NameMRS. KIMBERLY DAWN PUCKETTCredential: PHARMD
Location Address212 BONNER MALL WAYPonderay, ID 83852-9748
Mailing Address212 Bonner Mall WayPonderay, ID 83852-9748 · (208) 255-8066 · Fax (208) 263-6623
Phone(208) 255-8066
Fax(208) 263-6623
Sole ProprietorYes
Enumeration DateAugust 22, 2013
✔ NPI 1700210085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in ID · P5173
Definition
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.
212 BONNER MALL WAY, Ponderay, ID 83852
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YOKES FOOD INC
Pharmacy (Community/Retail Pharmacy)
212 BONNER MALL WAY
PONDERAY, ID 83852
Bonner County (208) 265-8066
BRUCE SPRADLIN
Pharmacist
212 BONNER MALL WAY
PONDERAY, ID 83852
Bonner County (208) 265-8066

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Puckett's NPI number?

The NPI number for Kimberly Puckett is 1700210085. It was assigned to this individual provider in the NPPES registry on August 22, 2013.

Where is Kimberly Puckett located?

Kimberly Puckett practices at 212 Bonner Mall Way, Ponderay, ID 83852. The listed phone number is (208) 255-8066.

What is Kimberly Puckett's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Kimberly Puckett was last updated on August 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.