DR. JACLYN KOTULA (NPI# 1437678059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437678059 |
| Entity Type | Individual |
| Full Name | DR. JACLYN KOTULA |
| Credential | PHARMD |
| Practice Address |
Hwy 491 N Shiprock NM 87420 |
| Mailing Address |
2213 E 18th St Farmington NM 87401-7530 |
| Practice Telephone | 5053687266 |
| Mailing Telephone | 5858159277 |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2018-06-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
060454 | NY | Pharmacy Service Providers |
| Street Address |
HWY 491 N |
| City | SHIPROCK |
| State | NM |
| Zip Code | 87420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063679652 | Daniel Langsam | Pediatrics | Hwy 491 N, Northern Navajo Medical Center, Shiprock, NM 87420 | 2008-05-21 |
| 1902384084 | Katherine Vodovoz | Pharmacist | Hwy 491 N, Shiprock, NM 87420 | 2018-08-01 |
| 1255833018 | Madison Lee Adams | Pharmacist | Hwy 491 N, Pharmacy Dept, Shiprock, NM 87420 | 2018-03-07 |
| 1932366382 | Travis James Mellon | Emergency Medicine | Hwy 491 N, Northern Navajo Medical Center, Shiprock, NM 87420 | 2008-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003424383 | Ciara Hansen | Psychologist | Us- 491, Shiprock, NM 87420 | 2020-07-22 |
| 1013540848 | Kelsi Marie Hartwig | Dental Hygienist | Highway 491 North, Yucca Street, Shiprock, NM 87420 | 2020-02-20 |
| 1194364232 | Maria Sturtz | Pharmacist | Us Why 491 North, Shiprock, NM 87420 | 2020-01-06 |
| 1811533979 | Merissa Jo De La Garza | Pharmacist | Highway 491 S, Shiprock, NM 87420 | 2019-11-25 |
| 1619528510 | Heather Scott | Psychologist | Highway 64, Old High School Road, Shiprock, NM 87420 | 2019-09-23 |
| 1396305264 | Malaura Creager | Pharmacist | North Hwy 491, Shiprock, NM 87420 | 2019-06-13 |
| 1275011488 | Dawn Fowler | Registered Nurse | Us Highway 64, Shiprock, NM 87420 | 2018-07-31 |
| 1902384373 | Brittany Jones | Occupational Therapy Assistant | Us 64, Old High School Rd., Shiprock, NM 87420 | 2018-07-30 |
| 1528561701 | Patricia D Suarez | Registered Nurse | Central Consolidated School of New Mexico, Hwy 64, Old High School Road, Shiprock, NM 87420 | 2018-03-14 |
| 1023549284 | Ellen Liversidge | Speech-Language Pathologist | Hwy 64, Old High School Rd., Shiprock, NM 87420 | 2017-03-21 |
| Find all providers in zip 87420 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780030973 | Welly Agate | Pharmacist | U.S. Hwy. 491 North, Shiprock, NM 87420-0160 | 2016-05-06 |
| 1497368567 | Melvina Lake | Pharmacist | Us Highway 491 North, Shiprock, NM 87420 | 2020-08-28 |
| 1902384084 | Katherine Vodovoz | Pharmacist | Hwy 491 N, Shiprock, NM 87420 | 2018-08-01 |
| 1467844043 | Fiona Chao | Pharmacist | Us Hwy 491, Shiprock, NM 87420 | 2015-02-19 |
| 1679881437 | Patrick Covert Harper | Pharmacist | Us Hwy 491 North, Shiprock, NM 87420-0160 | 2010-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426016 | Natalia Carmen Mendez | Pharmacist | 409 Kathleen Pl, Farmington, NM 87401-3535 | 2020-08-04 |
| 1346897162 | Kali Autrey | Pharmacist | Junction Hwy 371 and Rt 9, Crownpoint, NM 87313 | 2019-08-26 |
| 1831752286 | Eillim De Jesus Rentas | Pharmacist | 6301 Alameda Blvd Ne Unit 1051, Albuquerque, NM 87113-2583 | 2019-04-20 |
| 1124594148 | Danielle Schavz | Pharmacist | 1691 Galisteo St Ste A, Santa Fe, NM 87505-4781 | 2018-10-17 |
| 1720589336 | Colin Wingfield Williams | Pharmacist | 8100 Constitution Pl Ne Ste 300, Albuquerque, NM 87110-7643 | 2018-02-28 |
| 1720501489 | Julia Poynor Lawrence | Pharmacist | 2705 Highland Rd, Roswell, NM 88201-1330 | 2017-07-24 |
| 1467836502 | Quentin Cooper Florence | Pharmacist | 44 Calle Del Media, Tijeras, NM 87059 | 2015-07-18 |
| 1669855698 | Krystle Tapia | Pharmacist | 601 Menaul Blvd Ne, Unit 203, Albuquerque, NM 87107-1531 | 2015-07-08 |
| 1386044006 | Richard Groh | Pharmacist | 905 Saunders Dr, Roswell, NM 88201-1002 | 2014-08-29 |
| 1518366434 | Irene Gale | Pharmacist | 3 Maize Trl, Placitas, NM 87043-8339 | 2014-08-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.