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General NPI Number Information
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NPI Number | 1053588541
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Entity Type | Individual
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Provider Name | COURTNEY FRALEY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 2498 CUMBERLAND PKWY SE
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City | ATLANTA
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State | GA
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Zip | 30339-4502
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Country | US
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Telephone | 770-432-1533
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Fax | 770-432-5559
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Provider Business Mailing Address
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Address Line | 1115 KIM KENT DR
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City | RICHMOND
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State | KY
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Zip | 40475-2901
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 013797
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License Number State | KY
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