Provider Demographics
NPI:1962782508
Name:SIBERT, JANICE (RPH)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:
Last Name:SIBERT
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 1:520 LYNDON LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4618
Mailing Address - Country:US
Mailing Address - Phone:502-426-1373
Mailing Address - Fax:502-426-3237
Practice Address - Street 1:520 LYNDON LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4618
Practice Address - Country:US
Practice Address - Phone:502-426-1373
Practice Address - Fax:502-426-3237
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008208183500000X
TN005154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist