Jaclyn Kotula, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

060454 Issued in NY

Practice address

Hwy 491 N
Shiprock, NM 87420

Phone

(505) 368-7266

NPI assigned

Sep 14, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1437678059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 E 18TH ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874017530",
            "telephone_number": "585-815-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 491 N",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-7266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTULA",
        "first_name": "JACLYN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NY",
            "license": "060454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Jon King, RT
• Linda Kay Knedler, MD
• Michael John Kop, RDMS
• Thad A Koppenhafer, PHARMD
• Thomas Albert Korbitz, DDS
• Heather C Kovich, MD
• Clinton Edward Krestel, PHARM D
• Ryan Jean Kronen, MD
• April Kunsman, PA-C
• Tracy L. Kurek, PAC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Shiprock, NM
• Providers in Shiprock, NM by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.