Provider Demographics
NPI:1073815593
Name:FELTNER, BROOKE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:FELTNER
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 1:810 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-1428
Mailing Address - Country:US
Mailing Address - Phone:606-878-7713
Mailing Address - Fax:606-878-9458
Practice Address - Street 1:810 E 4TH ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-1428
Practice Address - Country:US
Practice Address - Phone:606-878-7713
Practice Address - Fax:606-878-9458
Is Sole Proprietor?:No
Enumeration Date:2010-12-04
Last Update Date:2010-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist