Provider Demographics
NPI:1184217747
Name:CORLETT, KATHRYN (PHARMD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:CORLETT
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 1:1660 HAMILTON DR
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-4400
Mailing Address - Country:US
Mailing Address - Phone:440-539-1219
Mailing Address - Fax:
Practice Address - Street 1:214 W BOWERY ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1046
Practice Address - Country:US
Practice Address - Phone:330-543-4299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031355091835C0205X, 1835P0200X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835C0205XPharmacy Service ProvidersPharmacistCritical Care
No1835P0200XPharmacy Service ProvidersPharmacistPediatrics