Provider Demographics
NPI:1144507377
Name:CATTERLIN, CHARLENE MARIE (PHARM D)
Entity type:Individual
Prefix:MS
First Name:CHARLENE
Middle Name:MARIE
Last Name:CATTERLIN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8233 S JAMESTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-1618
Mailing Address - Country:US
Mailing Address - Phone:918-605-1033
Mailing Address - Fax:
Practice Address - Street 1:22361 S BALD HILL RD
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-1635
Practice Address - Country:US
Practice Address - Phone:918-453-5603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15018183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist