Provider Demographics
NPI:1285009951
Name:SCOTT, KATELYNN DANIELLE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KATELYNN
Middle Name:DANIELLE
Last Name:SCOTT
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 1:150 FARMBROOK LN
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-9383
Mailing Address - Country:US
Mailing Address - Phone:989-370-3164
Mailing Address - Fax:989-732-8952
Practice Address - Street 1:950 EDELWEISS VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-7441
Practice Address - Country:US
Practice Address - Phone:989-732-8998
Practice Address - Fax:989-732-8952
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist