Provider Demographics
NPI:1578830154
Name:HOPE, KATHERINE N (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:N
Last Name:HOPE
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 1:310 ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:RUPERT
Mailing Address - State:ID
Mailing Address - Zip Code:83350-1756
Mailing Address - Country:US
Mailing Address - Phone:208-436-1200
Mailing Address - Fax:208-436-6121
Practice Address - Street 1:310 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:RUPERT
Practice Address - State:ID
Practice Address - Zip Code:83350-1756
Practice Address - Country:US
Practice Address - Phone:208-436-1200
Practice Address - Fax:208-436-6121
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-25
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6433183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP6433OtherPHARMACY LICENSE