Provider Demographics
NPI:1003401597
Name:CROUCH, JULIE A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:CROUCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DRY RIDGE
Mailing Address - State:KY
Mailing Address - Zip Code:41035-7329
Mailing Address - Country:US
Mailing Address - Phone:859-823-5271
Mailing Address - Fax:
Practice Address - Street 1:24 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DRY RIDGE
Practice Address - State:KY
Practice Address - Zip Code:41035-7329
Practice Address - Country:US
Practice Address - Phone:859-823-5271
Practice Address - Fax:859-823-0039
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY015988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist