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General NPI Number Information
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NPI Number | 1174355283
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Entity Type | Individual
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Provider Name | KATELYN NICOLE DOUGAN
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Gender | Female
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Dates
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Enumeration Date | 08/16/2024
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 1195 BARRET BLVD
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City | HENDERSON
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State | KY
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Zip | 42420-7508
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Country | US
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Telephone | 270-826-6926
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Fax |
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Provider Business Mailing Address
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Address Line | 6922 RUSSELL PL
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City | CHANDLER
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State | IN
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Zip | 47610-9694
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Country | US
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Telephone | 812-483-3413
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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 | 024555
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License Number State | KY
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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 | 26030850A
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License Number State | IN
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