Provider Demographics
NPI:1083137392
Name:CAMPBELL, KATHRYN LAURA GOUZOULES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:LAURA GOUZOULES
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 CHESTNUT BLUFFS LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9163
Mailing Address - Country:US
Mailing Address - Phone:919-308-1082
Mailing Address - Fax:
Practice Address - Street 1:520 LAKE COOK RD STE 500
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5633
Practice Address - Country:US
Practice Address - Phone:888-600-8116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist