Provider Demographics
NPI:1336423425
Name:SPIVEY, JULIE K (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:K
Last Name:SPIVEY
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 1:627 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-1207
Mailing Address - Country:US
Mailing Address - Phone:859-246-7430
Mailing Address - Fax:859-246-7677
Practice Address - Street 1:627 W 4TH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1207
Practice Address - Country:US
Practice Address - Phone:859-246-7430
Practice Address - Fax:859-246-7677
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013152183500000X
MO2004003289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2004003289OtherMISSOURI BOARD OF PHARMACY LICENSE NUMBER
KY013152OtherKY BOARD OF PHARMACY LICENSE NUMBER