Provider Demographics
NPI:1740916782
Name:BEELUT, KAAINAAT
Entity type:Individual
Prefix:
First Name:KAAINAAT
Middle Name:
Last Name:BEELUT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 NIAGRA PRESERVATION CIR APT 203
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-6136
Mailing Address - Country:US
Mailing Address - Phone:313-597-6723
Mailing Address - Fax:
Practice Address - Street 1:6660 W MAIN ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-3962
Practice Address - Country:US
Practice Address - Phone:269-372-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-30
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53510171221835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy