Provider Demographics
NPI:1467837138
Name:HATFIELD, HOLLY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:HATFIELD
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 1:7684 FRANKFORT RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8403
Mailing Address - Country:US
Mailing Address - Phone:502-727-5408
Mailing Address - Fax:
Practice Address - Street 1:2700 STANLEY GAULT PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-5132
Practice Address - Country:US
Practice Address - Phone:502-254-1024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST021056183500000X
KY012734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist