Provider Demographics
NPI:1417262098
Name:JOLLY, BARBARA LEE (RPH, MPA)
Entity Type:Individual
Prefix:PROF
First Name:BARBARA
Middle Name:LEE
Last Name:JOLLY
Suffix:
Gender:F
Credentials:RPH, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 GARDINER LN
Mailing Address - Street 2:SULLIVAN UNIVERSITY COLLEGE OF PHARMACY
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-2962
Mailing Address - Country:US
Mailing Address - Phone:502-413-8956
Mailing Address - Fax:502-515-4669
Practice Address - Street 1:2100 GARDINER LN
Practice Address - Street 2:SULLIVAN UNIVERSITY COLLEGE OF PHARMACY
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2962
Practice Address - Country:US
Practice Address - Phone:502-413-8956
Practice Address - Fax:502-515-4669
Is Sole Proprietor?:No
Enumeration Date:2010-08-08
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY010129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist