Healthcare Provider Details

I. General information

NPI: 1912832387
Provider Name (Legal Business Name): DR. KAITLYN PEELER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887 N BRIDGE ST
CHILLICOTHEE OH
45601-1704
US

IV. Provider business mailing address

887 N BRIDGE ST
CHILLICOTHEE OH
45601-1704
US

V. Phone/Fax

Practice location:
  • Phone: 740-775-8467
  • Fax: 740-672-5555
Mailing address:
  • Phone: 740-775-8467
  • Fax: 740-672-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03445992
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: