Provider Demographics
NPI:1073834842
Name:BROWN, KATHYRN CHELEKIS (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATHYRN
Middle Name:CHELEKIS
Last Name:BROWN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19290 TONKAWAN RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-5029
Mailing Address - Country:US
Mailing Address - Phone:760-242-1118
Mailing Address - Fax:
Practice Address - Street 1:17441 MAIN ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-6268
Practice Address - Country:US
Practice Address - Phone:760-948-4430
Practice Address - Fax:760-947-7629
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH33038183500000X
FLPS18240183500000X
OH03112181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist