Provider Demographics
NPI:1033717822
Name:PUTERBAUGH, JULIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:PUTERBAUGH
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 1:617 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:KY
Mailing Address - Zip Code:42220-8815
Mailing Address - Country:US
Mailing Address - Phone:859-224-2369
Mailing Address - Fax:
Practice Address - Street 1:1213 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-4986
Practice Address - Country:US
Practice Address - Phone:270-886-4594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0215471835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist