Provider Demographics
NPI:1629685268
Name:NEWSOME, KATHERINE NICOLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:NICOLE
Last Name:NEWSOME
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 1:2301 RUNNING HORSE RD
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-7703
Mailing Address - Country:US
Mailing Address - Phone:816-431-0327
Mailing Address - Fax:816-431-5648
Practice Address - Street 1:2301 RUNNING HORSE RD
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-7703
Practice Address - Country:US
Practice Address - Phone:816-431-0327
Practice Address - Fax:816-431-5648
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016037817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist