Provider Demographics
NPI:1083299770
Name:FROST, KAITLIN MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAITLIN
Middle Name:MARIE
Last Name:FROST
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 1:2400 S COUNTY ROAD 125 W
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-8966
Mailing Address - Country:US
Mailing Address - Phone:765-465-9425
Mailing Address - Fax:
Practice Address - Street 1:4200 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-3493
Practice Address - Country:US
Practice Address - Phone:765-827-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-14
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028867A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist