Provider Demographics
NPI:1043798796
Name:HITCH, KATELYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:HITCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:WEBSTER
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:11416 OCEAN GTWY
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-2549
Mailing Address - Country:US
Mailing Address - Phone:410-629-1842
Mailing Address - Fax:
Practice Address - Street 1:11416 OCEAN GTWY
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-2549
Practice Address - Country:US
Practice Address - Phone:410-629-1842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-04
Last Update Date:2018-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24266183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist