Provider Demographics
NPI:1689061962
Name:TUMINELLO, KATHY LORRAINE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:LORRAINE
Last Name:TUMINELLO
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 1:146 PINEY DR
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81122-9392
Mailing Address - Country:US
Mailing Address - Phone:318-349-5328
Mailing Address - Fax:
Practice Address - Street 1:146 PINEY DR
Practice Address - Street 2:
Practice Address - City:BAYFIELD
Practice Address - State:CO
Practice Address - Zip Code:81122-9392
Practice Address - Country:US
Practice Address - Phone:318-349-5328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA 0019736183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist