Provider Demographics
NPI:1548019656
Name:GUNTER, KATHLEEN KALTENBACH (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:KALTENBACH
Last Name:GUNTER
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12409 GREENLEA CHASE W
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-6019
Mailing Address - Country:US
Mailing Address - Phone:405-919-3159
Mailing Address - Fax:
Practice Address - Street 1:625 NE 36TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-7201
Practice Address - Country:US
Practice Address - Phone:405-669-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10767183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist