Provider Demographics
NPI:1336515352
Name:DEINES, NANCY E (RPH)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:E
Last Name:DEINES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11601 SHELBYVILLE RD., SUITE A
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1309
Mailing Address - Country:US
Mailing Address - Phone:502-690-2410
Mailing Address - Fax:502-690-2219
Practice Address - Street 1:11601 SHELBYVILLE RD., SUITE A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1309
Practice Address - Country:US
Practice Address - Phone:502-690-2410
Practice Address - Fax:502-690-2219
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist