Provider Demographics
NPI:1225496425
Name:ROUSSEAU, LINDSAY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:
Last Name:ROUSSEAU
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 1:635 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:KY
Mailing Address - Zip Code:41094-7841
Mailing Address - Country:US
Mailing Address - Phone:859-379-0030
Mailing Address - Fax:859-379-0031
Practice Address - Street 1:635 CHESTNUT DR
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:KY
Practice Address - Zip Code:41094-7841
Practice Address - Country:US
Practice Address - Phone:859-379-0030
Practice Address - Fax:859-379-0031
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist