Provider Demographics
NPI:1124398466
Name:WINFREY, KERRY CAPPS (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:CAPPS
Last Name:WINFREY
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 1:4291 WOODBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-7625
Mailing Address - Country:US
Mailing Address - Phone:850-251-3341
Mailing Address - Fax:850-580-1739
Practice Address - Street 1:4291 WOODBRIDGE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-7625
Practice Address - Country:US
Practice Address - Phone:850-251-3341
Practice Address - Fax:850-580-1739
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0034384183500000X
GARPH024711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist