Healthcare Provider Details

I. General information

NPI: 1942822655
Provider Name (Legal Business Name): KATELYNN MARIE DORAN PHARMD, BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W FOREVERGREEN RD STE 1605
NORTH LIBERTY IA
52317-9848
US

IV. Provider business mailing address

1200 WOOD LILY RD
SOLON IA
52333-4727
US

V. Phone/Fax

Practice location:
  • Phone: 319-485-0300
  • Fax:
Mailing address:
  • Phone: 405-628-5935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23745
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License Number23745
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: