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General NPI Number Information
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NPI Number | 1396449161
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Entity Type | Individual
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Provider Name | SHELBY JO CRAWHORN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 4003 KRESGE WAY STE 400
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City | LOUISVILLE
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State | KY
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Zip | 40207-4652
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Country | US
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Telephone | 502-928-3114
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Fax |
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Provider Business Mailing Address
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Address Line | 2735 CRESCENT HILL DR NE
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City | CORYDON
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State | IN
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Zip | 47112-8295
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Country | US
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Telephone | 812-736-6105
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 26027876A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 020173
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License Number State | KY
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