Provider Demographics
NPI:1295335453
Name:MEANS, KATRINA DION (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:DION
Last Name:MEANS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 INDIAN DR
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-7663
Mailing Address - Country:US
Mailing Address - Phone:478-374-3403
Mailing Address - Fax:478-374-3433
Practice Address - Street 1:1099 INDIAN DR
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-7663
Practice Address - Country:US
Practice Address - Phone:478-374-3403
Practice Address - Fax:478-374-3433
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021674183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist