Provider Demographics
NPI:1578897419
Name:FIELDS, KATHERINE VAUGHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:VAUGHN
Last Name:FIELDS
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 1:415 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45068-9553
Mailing Address - Country:US
Mailing Address - Phone:513-897-7076
Mailing Address - Fax:513-897-1446
Practice Address - Street 1:415 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:45068-9553
Practice Address - Country:US
Practice Address - Phone:513-897-7076
Practice Address - Fax:513-897-1446
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03227861-21835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03227861-2OtherSTATE BOARD OF PHARMACY