Provider Demographics
NPI:1770834814
Name:SELLERS, KATIE RUSHING (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:RUSHING
Last Name:SELLERS
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 1:93 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35213-3653
Mailing Address - Country:US
Mailing Address - Phone:205-914-3076
Mailing Address - Fax:
Practice Address - Street 1:93 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35213-3653
Practice Address - Country:US
Practice Address - Phone:205-914-3076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17053183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL471426OtherNABP