Provider Demographics
NPI:1093091696
Name:STRONG, KATHERINE (PHARM D)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:STRONG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 INVERNESS DR
Mailing Address - Street 2:
Mailing Address - City:HUBERT
Mailing Address - State:NC
Mailing Address - Zip Code:28539-4607
Mailing Address - Country:US
Mailing Address - Phone:920-277-5166
Mailing Address - Fax:
Practice Address - Street 1:1600 GUM BRANCH RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-5201
Practice Address - Country:US
Practice Address - Phone:910-478-4949
Practice Address - Fax:910-478-4946
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16423-40183500000X
NC28215183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist