Provider Demographics
NPI:1205825635
Name:DAVIDSON, SHARON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:DAVIDSON
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 1:6600 HIGHWAY 490
Mailing Address - Street 2:
Mailing Address - City:EAST BERNSTADT
Mailing Address - State:KY
Mailing Address - Zip Code:40729
Mailing Address - Country:US
Mailing Address - Phone:606-843-2040
Mailing Address - Fax:
Practice Address - Street 1:211 US HIGHWAY 421 S
Practice Address - Street 2:
Practice Address - City:MC KEE
Practice Address - State:KY
Practice Address - Zip Code:40447-9425
Practice Address - Country:US
Practice Address - Phone:606-287-7104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012702183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY012702OtherSTATE LICENSE