Provider Demographics
NPI:1114049442
Name:WHITLEY, AMY BROWN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:BROWN
Last Name:WHITLEY
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 1:3044 BLACKFORD PKWY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-9027
Mailing Address - Country:US
Mailing Address - Phone:859-263-7986
Mailing Address - Fax:
Practice Address - Street 1:2700 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509
Practice Address - Country:US
Practice Address - Phone:859-269-5396
Practice Address - Fax:859-269-1028
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011985183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist