Provider Demographics
NPI:1275819690
Name:MCCRACKEN, SHEILA MARIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:MARIE
Last Name:MCCRACKEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 BUTTERMILK PIKE
Mailing Address - Street 2:
Mailing Address - City:CRESCENT SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1302
Mailing Address - Country:US
Mailing Address - Phone:859-344-1824
Mailing Address - Fax:859-344-8204
Practice Address - Street 1:606 BUTTERMILK PIKE
Practice Address - Street 2:
Practice Address - City:CRESCENT SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:41017-1302
Practice Address - Country:US
Practice Address - Phone:859-344-1824
Practice Address - Fax:859-344-8204
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist