Provider Demographics
NPI:1093830705
Name:KELLEY, DEBRA HEDGER (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:HEDGER
Last Name:KELLEY
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 1:6483 OLD RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-9303
Mailing Address - Country:US
Mailing Address - Phone:859-263-4264
Mailing Address - Fax:
Practice Address - Street 1:2312 ALEXANDRIA DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3229
Practice Address - Country:US
Practice Address - Phone:859-276-5344
Practice Address - Fax:859-223-0490
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist