Provider Demographics
NPI:1992111447
Name:BIERENS, KIMBERLY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:BIERENS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:THAYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM,D,
Mailing Address - Street 1:1921 FRANKFORT AVE
Mailing Address - Street 2:#3
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-3084
Mailing Address - Country:US
Mailing Address - Phone:502-609-4892
Mailing Address - Fax:
Practice Address - Street 1:3600 MALL RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-5403
Practice Address - Country:US
Practice Address - Phone:502-456-1441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-05
Last Update Date:2014-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY017011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist