Provider Demographics
NPI:1194833285
Name:HENRY, KATHY LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:LYNN
Last Name:HENRY
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 1:112 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:CROPWELL
Mailing Address - State:AL
Mailing Address - Zip Code:35054-3524
Mailing Address - Country:US
Mailing Address - Phone:205-884-1223
Mailing Address - Fax:205-884-0730
Practice Address - Street 1:1009 MARTIN ST S
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35128-2360
Practice Address - Country:US
Practice Address - Phone:205-884-1115
Practice Address - Fax:205-884-0730
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist