Provider Demographics
NPI:1386929446
Name:BETTS, BEVERLY LYNN (PHARMD)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:LYNN
Last Name:BETTS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:BEVERLY
Other - Middle Name:LYNN
Other - Last Name:BETTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1056 DELLA DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2219
Mailing Address - Country:US
Mailing Address - Phone:859-277-8226
Mailing Address - Fax:
Practice Address - Street 1:2209 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-1306
Practice Address - Country:US
Practice Address - Phone:859-269-8832
Practice Address - Fax:859-269-3186
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012278183500000X
FLPS0036248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist