Healthcare Provider Details

I. General information

NPI: 1407139702
Provider Name (Legal Business Name): VALERIE MICHELLE EARLY PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2011
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CARDINAL DR STE 413
ELIZABETHTOWN KY
42701-2795
US

IV. Provider business mailing address

200 CARDINAL DR STE 413
ELIZABETHTOWN KY
42701-2795
US

V. Phone/Fax

Practice location:
  • Phone: 270-979-3742
  • Fax:
Mailing address:
  • Phone: 270-979-3742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number015139
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number015139
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: