Provider Demographics
NPI:1265106173
Name:KAUTZ, ERIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:KAUTZ
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 1:1021 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3046
Mailing Address - Country:US
Mailing Address - Phone:402-462-4466
Mailing Address - Fax:402-462-4180
Practice Address - Street 1:1021 W 14TH ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3046
Practice Address - Country:US
Practice Address - Phone:402-462-4466
Practice Address - Fax:402-462-4180
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist