Provider Demographics
NPI:1225638778
Name:GEORGE, SIERRA JO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SIERRA
Middle Name:JO
Last Name:GEORGE
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 1:305 LETTON DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2252
Mailing Address - Country:US
Mailing Address - Phone:859-987-4213
Mailing Address - Fax:859-987-7820
Practice Address - Street 1:305 LETTON DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2252
Practice Address - Country:US
Practice Address - Phone:859-987-4213
Practice Address - Fax:859-987-7820
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist