Provider Demographics
NPI:1831565001
Name:MAYR, KATRINA RAELYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:RAELYNN
Last Name:MAYR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:RAELYNN
Other - Last Name:SKARDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3904 RETREAT DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MT
Mailing Address - Zip Code:59044-9629
Mailing Address - Country:US
Mailing Address - Phone:916-747-2442
Mailing Address - Fax:
Practice Address - Street 1:1233 N 30TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0165
Practice Address - Country:US
Practice Address - Phone:406-237-5359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72999183500000X
MTPHA-PHA-369241835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist