Provider Demographics
NPI:1144724246
Name:KRUTSCH, KAYTLIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KAYTLIN
Middle Name:
Last Name:KRUTSCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KAYTLIN
Other - Middle Name:
Other - Last Name:HUSEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 WILLIAM LN
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-6497
Mailing Address - Country:US
Mailing Address - Phone:806-231-4944
Mailing Address - Fax:
Practice Address - Street 1:24 WILLIAM LN
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-6497
Practice Address - Country:US
Practice Address - Phone:806-231-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54775183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist