Healthcare Provider Details

I. General information

NPI: 1912517194
Provider Name (Legal Business Name): MARCELLE CURTIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12501 SHELBYVILLE RD
MIDDLETOWN KY
40243-1530
US

IV. Provider business mailing address

68 WEISSINGER CT
SHELBYVILLE KY
40065-8345
US

V. Phone/Fax

Practice location:
  • Phone: 502-244-7960
  • Fax:
Mailing address:
  • Phone: 502-321-4588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number012020
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: