Provider Demographics
NPI:1811286719
Name:RATHS, KATHRYN ANN (RPH)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:RATHS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MAYWOOD PL
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-5621
Mailing Address - Country:US
Mailing Address - Phone:651-489-1842
Mailing Address - Fax:
Practice Address - Street 1:9 W 14TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2478
Practice Address - Country:US
Practice Address - Phone:612-354-3400
Practice Address - Fax:612-677-3330
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114856183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist