Provider Demographics
NPI:1275756298
Name:RUFTY, SHONNA HALL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHONNA
Middle Name:HALL
Last Name:RUFTY
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 1:1061 BREEZY LN
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-9691
Mailing Address - Country:US
Mailing Address - Phone:859-985-8926
Mailing Address - Fax:
Practice Address - Street 1:500 NORTH HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:WHITLEY CITY
Practice Address - State:KY
Practice Address - Zip Code:42653
Practice Address - Country:US
Practice Address - Phone:606-376-9269
Practice Address - Fax:606-376-3307
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013355183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY013355OtherBOARD OF PHARM.STATE LIC