Provider Demographics
NPI:1245525757
Name:PASIK, KAITLYN ANNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:ANNE
Last Name:PASIK
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 1:4955 S M 88 HWY
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:MI
Mailing Address - Zip Code:49615-9082
Mailing Address - Country:US
Mailing Address - Phone:231-533-8649
Mailing Address - Fax:231-533-5331
Practice Address - Street 1:4955 S M 88 HWY
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:MI
Practice Address - Zip Code:49615-9082
Practice Address - Country:US
Practice Address - Phone:231-533-8649
Practice Address - Fax:231-533-5331
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist