Provider Demographics
NPI:1063608750
Name:MYERS, KATHRYN ELIZABETH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:MYERS
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 1:727 E 600 S
Mailing Address - Street 2:122
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2970
Mailing Address - Country:US
Mailing Address - Phone:801-953-0248
Mailing Address - Fax:
Practice Address - Street 1:50 N MEDICAL DR
Practice Address - Street 2:A050
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-5901
Practice Address - Country:US
Practice Address - Phone:801-585-9236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6623256-1701183500000X
NJ28RI03143400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist