Provider Demographics
NPI:1841880978
Name:TRUEBLOOD, KATHRYN NICOLE (PHARMD)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:NICOLE
Last Name:TRUEBLOOD
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 1:835 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-3131
Mailing Address - Country:US
Mailing Address - Phone:812-265-4621
Mailing Address - Fax:
Practice Address - Street 1:1955 HWY 227
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:KY
Practice Address - Zip Code:41008-8037
Practice Address - Country:US
Practice Address - Phone:502-732-4331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26026345A183500000X
KY018011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist