Provider Demographics
NPI:1104412766
Name:GUINN, PATTY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PATTY
Middle Name:
Last Name:GUINN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 W. LAKESHORE DR.
Mailing Address - Street 2:
Mailing Address - City:BURNSIDE
Mailing Address - State:KY
Mailing Address - Zip Code:42519
Mailing Address - Country:US
Mailing Address - Phone:606-305-1028
Mailing Address - Fax:606-561-9205
Practice Address - Street 1:51 W. LAKESHORE DR.
Practice Address - Street 2:
Practice Address - City:BURNSIDE
Practice Address - State:KY
Practice Address - Zip Code:42519
Practice Address - Country:US
Practice Address - Phone:606-305-1028
Practice Address - Fax:606-561-9205
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist