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General NPI Number Information
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NPI Number | 1427199959
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Entity Type | Individual
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Provider Name | KELLEY SUE SPENCER RPH
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Gender | Female
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 S MAIN ST
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City | VERSAILLES
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State | KY
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Zip | 40383-1214
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Country | US
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Telephone | 859-873-3007
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Fax |
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Provider Business Mailing Address
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Address Line | 1081 HIFNER RD
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City | VERSAILLES
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State | KY
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Zip | 40383-9626
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Country | US
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Telephone | 859-879-8392
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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 | 012620
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 040751-1
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License Number State | NY
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