Provider Demographics
NPI:1336922509
Name:MONSUE, KAITLYN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:
Last Name:MONSUE
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 1:275 WALTON DR
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:TN
Mailing Address - Zip Code:37185-3382
Mailing Address - Country:US
Mailing Address - Phone:931-296-9984
Mailing Address - Fax:
Practice Address - Street 1:275 WALTON DR
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:TN
Practice Address - Zip Code:37185-3382
Practice Address - Country:US
Practice Address - Phone:931-296-9984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47416183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist