Individual
DR. KATE KELCOURSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1 VA CTR, AUGUSTA, ME 04330-6719
(207) 623-8411
Mailing address
41 LIBERTY LN, APT 115, SOUTH PORTLAND, ME 04106-2090
(207) 623-8411
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR5405
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PR5405
PHARMACIST LICENSE
ME
Enumeration date
10/25/2006
Last updated
07/08/2007
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