Provider Demographics
NPI:1164001871
Name:ASKEW, KATIE LEIGH (RPH)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LEIGH
Last Name:ASKEW
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 1:2104 TWIN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-5276
Mailing Address - Country:US
Mailing Address - Phone:229-726-0562
Mailing Address - Fax:
Practice Address - Street 1:11049 NW STATE ROAD 20
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:FL
Practice Address - Zip Code:32321-6406
Practice Address - Country:US
Practice Address - Phone:850-643-5454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty