Provider Demographics
NPI:1578847851
Name:HANDEL, KATHRYN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:HANDEL
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 1:520 S EAGLE RD STE 1000
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-6353
Mailing Address - Country:US
Mailing Address - Phone:208-706-5255
Mailing Address - Fax:208-706-5253
Practice Address - Street 1:520 S EAGLE RD STE 1000
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-6353
Practice Address - Country:US
Practice Address - Phone:208-402-0154
Practice Address - Fax:208-402-0160
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist