Provider Demographics
NPI:1912389545
Name:GOULET, KATIE LEIGH (PHARMD, MSCR, BS)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:LEIGH
Last Name:GOULET
Suffix:
Gender:F
Credentials:PHARMD, MSCR, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 FOREST HILLS RD W
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-3408
Mailing Address - Country:US
Mailing Address - Phone:252-243-5445
Mailing Address - Fax:
Practice Address - Street 1:1601 FOREST HILLS RD W
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-3408
Practice Address - Country:US
Practice Address - Phone:252-243-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist