Individual
TINA SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
589 W HIGHWAY 92, WILLIAMSBURG, KY 40769-1684
(606) 546-4087
Mailing address
500 BRAMBLEWOOD DR, CORBIN, KY 40701-7437
(859) 626-2750
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
016068
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016068
STATE LICENSE
KY
Enumeration date
06/10/2020
Last updated
06/10/2020
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