Provider Demographics
NPI:1588497267
Name:GALEN, KATRINA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:
Last Name:GALEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:
Other - Last Name:KOTTWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11330 GRAVOIS RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SAPPINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63126-3687
Mailing Address - Country:US
Mailing Address - Phone:314-842-0910
Mailing Address - Fax:314-842-7982
Practice Address - Street 1:11330 GRAVOIS RD STE 202
Practice Address - Street 2:
Practice Address - City:SAPPINGTON
Practice Address - State:MO
Practice Address - Zip Code:63126-3687
Practice Address - Country:US
Practice Address - Phone:314-842-0910
Practice Address - Fax:314-842-7982
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014028389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist