Provider Demographics
NPI:1629830997
Name:PRANGA, KATRIANNA DOLORES (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATRIANNA
Middle Name:DOLORES
Last Name:PRANGA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATRIANNA
Other - Middle Name:DOLORES
Other - Last Name:SALTARELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:280 DAVID L GOLDFEIN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLOMAN AFB
Mailing Address - State:NM
Mailing Address - Zip Code:88330-8273
Mailing Address - Country:US
Mailing Address - Phone:575-572-0590
Mailing Address - Fax:575-572-5781
Practice Address - Street 1:280 DAVID L GOLDFEIN ST
Practice Address - Street 2:
Practice Address - City:HOLLOMAN AFB
Practice Address - State:NM
Practice Address - Zip Code:88330-8273
Practice Address - Country:US
Practice Address - Phone:575-572-0590
Practice Address - Fax:575-572-5781
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-1007871835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist