Provider Demographics
NPI:1841637618
Name:HARLAN, KATHRYN WALLS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:WALLS
Last Name:HARLAN
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 1:1955 W TRUCKERS DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-5637
Mailing Address - Country:US
Mailing Address - Phone:479-571-6860
Mailing Address - Fax:
Practice Address - Street 1:1955 W TRUCKERS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-5637
Practice Address - Country:US
Practice Address - Phone:479-571-6860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD-11778183500000X
TX46602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist