Provider Demographics
NPI:1285875187
Name:SUTTON, KATHRYN R (RP)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:R
Last Name:SUTTON
Suffix:
Gender:F
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-3832
Mailing Address - Country:US
Mailing Address - Phone:308-762-1258
Mailing Address - Fax:308-762-2126
Practice Address - Street 1:500 E 3RD ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-3832
Practice Address - Country:US
Practice Address - Phone:308-762-1258
Practice Address - Fax:308-762-2126
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist