Provider Demographics
NPI:1639696735
Name:FEARS, CAITLIN VICTORIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:VICTORIA
Last Name:FEARS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:VICTORIA
Other - Last Name:BUCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:809 SAINT ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6633
Mailing Address - Country:US
Mailing Address - Phone:504-920-0123
Mailing Address - Fax:
Practice Address - Street 1:5360 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-6548
Practice Address - Country:US
Practice Address - Phone:225-757-1023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64588183500000X
LAPST.022063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist