Provider Demographics
NPI:1699095380
Name:ROBERTSON, BRANDY MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:MARIE
Last Name:ROBERTSON
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:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:BARLOW
Mailing Address - State:KY
Mailing Address - Zip Code:42024-0415
Mailing Address - Country:US
Mailing Address - Phone:270-853-1286
Mailing Address - Fax:
Practice Address - Street 1:119 E CLAY ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:KY
Practice Address - Zip Code:42031-1222
Practice Address - Country:US
Practice Address - Phone:270-653-5361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014691183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist