Provider Demographics
NPI:1376827923
Name:STOCKSDALE, CHRISTIE A (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:A
Last Name:STOCKSDALE
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 1:700 ALGONQUIN PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40208-1651
Mailing Address - Country:US
Mailing Address - Phone:502-636-3441
Mailing Address - Fax:502-636-0563
Practice Address - Street 1:700 ALGONQUIN PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40208-1651
Practice Address - Country:US
Practice Address - Phone:502-636-3441
Practice Address - Fax:502-636-0563
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist