Provider Demographics
NPI:1548682669
Name:QUINN, KATHRYN (RPH)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 LOST CREEK LOOP
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36067-4232
Mailing Address - Country:US
Mailing Address - Phone:224-358-0672
Mailing Address - Fax:
Practice Address - Street 1:103 LOST CREEK LOOP
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-4232
Practice Address - Country:US
Practice Address - Phone:224-358-0672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13361183500000X
TX31659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist