Provider Demographics
NPI:1972857928
Name:BLANTON, KIMBERLY NACOLE (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:NACOLE
Last Name:BLANTON
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:NACOLE
Other - Last Name:FLYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3470 BLAZER PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509
Mailing Address - Country:US
Mailing Address - Phone:859-629-7117
Mailing Address - Fax:859-685-0161
Practice Address - Street 1:800 ROSE ST WHITNEY HENDRICKSON BLDG
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-1200
Practice Address - Country:US
Practice Address - Phone:593-230-2488
Practice Address - Fax:859-323-6109
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0145831835P1200X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy