Healthcare Provider Details

I. General information

NPI: 1457877268
Provider Name (Legal Business Name): KYLIE ALINDA YENNEY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 08/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 UNION BLVD
ENGLEWOOD OH
45322-2130
US

IV. Provider business mailing address

9760 FLAGSTONE WAY
WEST CHESTER OH
45069-7041
US

V. Phone/Fax

Practice location:
  • Phone: 937-836-5204
  • Fax:
Mailing address:
  • Phone: 937-216-0396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03237075
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: