Provider Demographics
NPI:1356945158
Name:HAUGHWOUT, KAITLIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KAITLIN
Middle Name:
Last Name:HAUGHWOUT
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 1:1120 CARLISLE RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-6202
Mailing Address - Country:US
Mailing Address - Phone:717-612-5063
Mailing Address - Fax:
Practice Address - Street 1:1120 CARLISLE RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-6202
Practice Address - Country:US
Practice Address - Phone:717-612-5063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP452926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty