Individual
DR. MARIE JEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
12501 SHELBYVILLE RD, LOUISVILLE, KY 40243-1530
(502) 244-7960
(502) 244-7982
Mailing address
14409 CHAMPION WOODS PL, LOUISVILLE, KY 40245-5202
(502) 749-3388
(502) 749-3389
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
012665
KY
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
012665
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012665
BOARD OF PHARMACY
KY
01
—
26028475A
BOARD OF PHARMACY
IN
Enumeration date
10/29/2013
Last updated
12/18/2019
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