Provider Demographics
NPI:1861993628
Name:WINSLOW, KATELYN (PHARMD)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:WINSLOW
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 PLAIN ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-4972
Mailing Address - Country:US
Mailing Address - Phone:774-265-7616
Mailing Address - Fax:
Practice Address - Street 1:225 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:EAST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1986
Practice Address - Country:US
Practice Address - Phone:508-378-1370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist