Provider Demographics
NPI:1457634107
Name:CRUMBACKER, NANCY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:CRUMBACKER
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 1:5967 BUCK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FINCHVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40022-6743
Mailing Address - Country:US
Mailing Address - Phone:502-834-0519
Mailing Address - Fax:
Practice Address - Street 1:12101 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1044
Practice Address - Country:US
Practice Address - Phone:502-244-7037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist