Provider Demographics
NPI:1932719341
Name:YURKO, KAITLIN (PHARM D)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:YURKO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17859-8954
Mailing Address - Country:US
Mailing Address - Phone:570-854-7643
Mailing Address - Fax:
Practice Address - Street 1:1 WEIS PLZ
Practice Address - Street 2:
Practice Address - City:NANTICOKE
Practice Address - State:PA
Practice Address - Zip Code:18634-1618
Practice Address - Country:US
Practice Address - Phone:570-735-3979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-01
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP454752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist