Provider Demographics
NPI:1932493962
Name:BRUTOUT, CAITLIN FISCHER (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:FISCHER
Last Name:BRUTOUT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 N KEYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2488
Mailing Address - Country:US
Mailing Address - Phone:317-454-7505
Mailing Address - Fax:317-454-7415
Practice Address - Street 1:6101 N KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-2488
Practice Address - Country:US
Practice Address - Phone:317-454-7505
Practice Address - Fax:317-454-7415
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023351A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist