Provider Demographics
NPI:1265716013
Name:DYER, KATHERYN LOUISE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KATHERYN
Middle Name:LOUISE
Last Name:DYER
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 1:131 RACINE DR
Mailing Address - Street 2:STE 100
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-8777
Mailing Address - Country:US
Mailing Address - Phone:910-784-9545
Mailing Address - Fax:910-784-9645
Practice Address - Street 1:3069 RICHLANDS HWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-2976
Practice Address - Country:US
Practice Address - Phone:910-219-0490
Practice Address - Fax:910-219-0496
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-29522183500000X
NC21671183500000X
CA63242183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist