Provider Demographics
NPI:1316589583
Name:TAYLOR, KATHERYN M (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:KATHERYN
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 W 600 S
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-2721
Mailing Address - Country:US
Mailing Address - Phone:801-376-1264
Mailing Address - Fax:
Practice Address - Street 1:632 S 100 W
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-2864
Practice Address - Country:US
Practice Address - Phone:801-465-2591
Practice Address - Fax:801-465-5198
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT142348-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist