Provider Demographics
NPI:1447776489
Name:KUVSHINIKOV, JULIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KUVSHINIKOV
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 1:10650 N EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16423-1756
Mailing Address - Country:US
Mailing Address - Phone:843-991-6977
Mailing Address - Fax:
Practice Address - Street 1:2067 INTERCHANGE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-8315
Practice Address - Country:US
Practice Address - Phone:814-868-7923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist