Provider Demographics
NPI:1144504838
Name:NELSON, BARBARA JO (PHARMD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JO
Last Name:NELSON
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 3191
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-3191
Mailing Address - Country:US
Mailing Address - Phone:859-979-3949
Mailing Address - Fax:
Practice Address - Street 1:1775 HIGHWAY 192 W
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-1676
Practice Address - Country:US
Practice Address - Phone:606-877-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist