Provider Demographics
NPI:1285068338
Name:CATHCART, KRISTIN (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:CATHCART
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 CARRIAGE CLUB DR
Mailing Address - Street 2:APT 6-207
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9003
Mailing Address - Country:US
Mailing Address - Phone:775-513-9983
Mailing Address - Fax:
Practice Address - Street 1:127 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-8096
Practice Address - Country:US
Practice Address - Phone:704-892-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23584183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist