Provider Demographics
NPI:1467521690
Name:GATRELL, KIMBERLY FRAZIER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:FRAZIER
Last Name:GATRELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9079 LONNIE HARRIS RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-7604
Mailing Address - Country:US
Mailing Address - Phone:910-322-6034
Mailing Address - Fax:
Practice Address - Street 1:1241 DABNEY DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-3558
Practice Address - Country:US
Practice Address - Phone:252-438-2539
Practice Address - Fax:252-738-9758
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17664183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist