Provider Demographics
NPI:1114575479
Name:JOSIE, KARSTEN MICHAEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KARSTEN
Middle Name:MICHAEL
Last Name:JOSIE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 WINCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:KANAB
Mailing Address - State:UT
Mailing Address - Zip Code:84741-3000
Mailing Address - Country:US
Mailing Address - Phone:435-690-9253
Mailing Address - Fax:
Practice Address - Street 1:14 E CENTER ST
Practice Address - Street 2:
Practice Address - City:KANAB
Practice Address - State:UT
Practice Address - Zip Code:84741-3542
Practice Address - Country:US
Practice Address - Phone:435-644-2693
Practice Address - Fax:435-644-2702
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8627231-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist