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General NPI Number Information
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NPI Number | 1558610378
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Entity Type | Individual
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Provider Name | KATIE LYNN GRILLEY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 06/07/2025
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Provider Practice Location Address
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Address Line | 200 CONWAY DR
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City | KALISPELL
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State | MT
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Zip | 59901-3112
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Country | US
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Telephone | 406-751-7600
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Fax | 406-257-5230
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Provider Business Mailing Address
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Address Line | 619 MOUNTAIN VIEW DR
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City | KALISPELL
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State | MT
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Zip | 59901-6699
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Country | US
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Telephone | 406-249-6487
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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 | PHA-PHA-LIC-12408
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License Number State | MT
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