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General NPI Number Information
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NPI Number | 1003401613
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Entity Type | Individual
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Provider Name | TRACY LEE KITCHENS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/05/2021
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 7714 HEMLOCK SEED DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-5318
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Country | US
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Telephone | 815-673-7450
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Fax |
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Provider Business Mailing Address
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Address Line | 7714 HEMLOCK SEED DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-5318
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Country | US
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Telephone | 815-673-7450
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 67098
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH.42289
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 46872
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH031715
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License Number State | GA
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