Individual
VALARIE WEEDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8166
Mailing address
601 JOEL DRIVE, FORT CAMPBELL, KY 42223
(270) 412-5175
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
13753
KY
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
13753
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13753
STATE LICENSE
KY
Enumeration date
07/09/2015
Last updated
05/24/2023
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