Provider Demographics
NPI:1033368931
Name:BREEZE, KATY M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATY
Middle Name:M
Last Name:BREEZE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 JOHN ALDEN LANE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504
Mailing Address - Country:US
Mailing Address - Phone:859-455-9979
Mailing Address - Fax:859-223-0502
Practice Address - Street 1:#2573 PALOMAR CENTRE DR
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513
Practice Address - Country:US
Practice Address - Phone:859-223-0701
Practice Address - Fax:859-223-0502
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008102183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist