Provider Demographics
NPI:1396753612
Name:OKULEY, KIEU MY (RPH)
Entity type:Individual
Prefix:MRS
First Name:KIEU
Middle Name:MY
Last Name:OKULEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 E SECOND ST
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-2405
Mailing Address - Country:US
Mailing Address - Phone:419-784-4800
Mailing Address - Fax:419-484-4777
Practice Address - Street 1:1245 E SECOND ST
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-2405
Practice Address - Country:US
Practice Address - Phone:419-784-4800
Practice Address - Fax:419-484-4777
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-20932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist