Provider Demographics
NPI:1528468279
Name:KINNEY, PATRICIA (BS PHARM)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:KINNEY
Suffix:
Gender:F
Credentials:BS PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 ELM ST
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-1610
Mailing Address - Country:US
Mailing Address - Phone:859-342-8680
Mailing Address - Fax:
Practice Address - Street 1:3071 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41018-1829
Practice Address - Country:US
Practice Address - Phone:859-331-6800
Practice Address - Fax:859-331-8304
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-31
Last Update Date:2014-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008725183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist