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General NPI Number Information
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NPI Number | 1942023098
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Entity Type | Individual
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Provider Name | KATHERINE NICOLE LOGAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 760 BLACKWEASEL ROAD
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City | BROWNING
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State | MT
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Zip | 59417
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Country | US
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Telephone | 406-338-8908
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Fax |
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Provider Business Mailing Address
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Address Line | 134 IZAAK WALTON INN RD
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City | ESSEX
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State | MT
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Zip | 59916-9721
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Country | US
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Telephone | 605-585-6537
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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 | 21891
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License Number State | MD
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