Provider Demographics
NPI:1982910030
Name:WELLER, KATIE F (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:F
Last Name:WELLER
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 1:102 WENDEE WAY
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-3531
Mailing Address - Country:US
Mailing Address - Phone:215-480-4367
Mailing Address - Fax:856-374-4070
Practice Address - Street 1:245 FRIES MILL RD
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2059
Practice Address - Country:US
Practice Address - Phone:856-374-4367
Practice Address - Fax:856-374-4070
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03359700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist