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General NPI Number Information
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NPI Number | 1659757540
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Entity Type | Individual
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Provider Name | COURTNEY KIVETT CAUDILL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/03/2015
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 550 WHITE OAK ST
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City | ASHEBORO
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State | NC
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Zip | 27203-4710
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Country | US
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Telephone | 336-625-1360
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Fax | 336-625-1889
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Provider Business Mailing Address
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Address Line | 7341 FERGUSON RD
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City | LIBERTY
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State | NC
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Zip | 27298-8513
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Country | US
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Telephone | 336-963-1026
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 700392
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License Number State | NC
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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 | 25319
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License Number State | NC
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