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General NPI Number Information
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NPI Number | 1467995811
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Entity Type | Individual
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Provider Name | KAITLYN HOTZ PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/01/2016
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 3820 S WESTERN AVE
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City | MARION
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State | IN
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Zip | 46953-4901
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Country | US
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Telephone | 765-677-6810
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Fax |
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Provider Business Mailing Address
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Address Line | 1514 N LAKESHORE DR
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City | MARION
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State | IN
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Zip | 46952-1586
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Country | US
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Telephone | 765-618-5662
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 26024551A
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License Number State | IN
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