Individual provider · NPI-1

Kaitlin K Beettner

Pharmacist · Tyler, TX

NPI number1659114247
StatusActive
Last updated in NPPESOct 19, 2026

Details

NPI
1659114247
Entity type
Individual (NPI-1)
Name
Kaitlin K Beettner
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 13, 2024
Certification date
Oct 19, 2026
Last updated
Oct 19, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist77521TXYes
333600000X Pharmacy43065TX

Practice location

800 E Dawson St
Tyler, TX 75701-2036

Phone 903-607-0109

Mailing address

800 E Dawson St
Tyler, TX 75701-2036

Phone 903-607-0109

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