Katherine Ann Anderson

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Dallas, GA

NPI 1982203113 · NPPES record last updated Oct 19, 2020

Key facts

NPI
1982203113
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
016191 (GA)
Practice address
457 Nathan Dean Blvd
Dallas, GA 30132-4911
Phone
(770) 443-8776
NPI assigned
Oct 19, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
016191GAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Kroger Co Current
since Apr 27, 2025
Accepting new patients
Kroger Co Past
since Oct 25, 2020
Accepting new patients

Locations

457 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 016191 GA Yes

Addresses

Primary practice location

457 Nathan Dean Blvd
Dallas, GA 30132-4911

Mailing address

457 Nathan Dean Blvd
Dallas, GA 30132-4911
Phone (770) 443-8776

Other providers in Dallas, GA

All providers in Dallas, GA · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Georgia

Sources for this page

Verify at the official NPI Registry.