Individual
STACI D YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
610 BYPASS RD, BRANDENBURG, KY 40108-1730
(270) 422-5300
Mailing address
2524 FAIRGROUNDS RD, BRANDENBURG, KY 40108-8700
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
012383
KY
Other
Enumeration date
03/30/2011
Last updated
03/30/2011
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