Provider Demographics
NPI:1598360687
Name:LENTZ, KATHERINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:LENTZ
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 1:2833 BELLA VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-3709
Mailing Address - Country:US
Mailing Address - Phone:479-876-2153
Mailing Address - Fax:479-876-2184
Practice Address - Street 1:2833 BELLA VISTA WAY
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72714-3709
Practice Address - Country:US
Practice Address - Phone:479-876-2153
Practice Address - Fax:479-876-2184
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist