Provider Demographics
NPI:1497164537
Name:WHIPPLE, CATHRYNN STEWART (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CATHRYNN
Middle Name:STEWART
Last Name:WHIPPLE
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 1:565 JENSEN GROVE DR
Mailing Address - Street 2:
Mailing Address - City:BLACKFOOT
Mailing Address - State:ID
Mailing Address - Zip Code:83221-1682
Mailing Address - Country:US
Mailing Address - Phone:208-785-0277
Mailing Address - Fax:208-785-0388
Practice Address - Street 1:565 JENSEN GROVE DR
Practice Address - Street 2:
Practice Address - City:BLACKFOOT
Practice Address - State:ID
Practice Address - Zip Code:83221-1682
Practice Address - Country:US
Practice Address - Phone:208-785-0277
Practice Address - Fax:208-785-0388
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-02
Last Update Date:2014-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6078183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist