Provider Demographics
NPI:1639779259
Name:MCDONALD, KATHRYN ELIZABETH (RPH)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 FOSS FLATS RD
Mailing Address - Street 2:
Mailing Address - City:N SANDWICH
Mailing Address - State:NH
Mailing Address - Zip Code:03259-3636
Mailing Address - Country:US
Mailing Address - Phone:603-520-8809
Mailing Address - Fax:
Practice Address - Street 1:46 N SOUTH RD
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5122
Practice Address - Country:US
Practice Address - Phone:603-356-3170
Practice Address - Fax:603-356-4133
Is Sole Proprietor?:No
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist