Provider Demographics
NPI:1639417884
Name:KITCHENS, CAROLINE MYERS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:MYERS
Last Name:KITCHENS
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 1:1321 ISLAND TOWN DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-9027
Mailing Address - Country:US
Mailing Address - Phone:901-482-3505
Mailing Address - Fax:
Practice Address - Street 1:300 WEST SERVICE ROAD
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301
Practice Address - Country:US
Practice Address - Phone:870-732-0283
Practice Address - Fax:870-732-4871
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35981183500000X
ARPD11698183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist