Provider Demographics
NPI:1366910689
Name:LECOMPTE, KERI (PHARMD)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:LECOMPTE
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 1:379 BREEZY HILL ACRES
Mailing Address - Street 2:
Mailing Address - City:NORTH FERRISBURGH
Mailing Address - State:VT
Mailing Address - Zip Code:05473-9608
Mailing Address - Country:US
Mailing Address - Phone:802-377-2979
Mailing Address - Fax:
Practice Address - Street 1:379 BREEZY HILL ACRES
Practice Address - Street 2:
Practice Address - City:NORTH FERRISBURGH
Practice Address - State:VT
Practice Address - Zip Code:05473-9608
Practice Address - Country:US
Practice Address - Phone:802-377-2979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0095293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist