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General NPI Number Information
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NPI Number | 1871140368
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Entity Type | Individual
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Provider Name | KATHERINE CONNELLY MCCLATCHY
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Gender | Female
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 7989 US HIGHWAY 64
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City | MEMPHIS
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State | TN
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Zip | 38133-4007
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Country | US
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Telephone | 901-384-0263
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Fax |
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Provider Business Mailing Address
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Address Line | 1173 UNION AVE APT 311
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City | MEMPHIS
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State | TN
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Zip | 38104-6671
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Country | US
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Telephone |
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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 | 43198
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License Number State | TN
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