Provider Demographics
NPI:1508146085
Name:BAUSCH, KIRSTEN COMPTON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:COMPTON
Last Name:BAUSCH
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 1:6617 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-2164
Mailing Address - Country:US
Mailing Address - Phone:859-342-7764
Mailing Address - Fax:859-342-0609
Practice Address - Street 1:6617 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2164
Practice Address - Country:US
Practice Address - Phone:859-342-7764
Practice Address - Fax:859-342-0609
Is Sole Proprietor?:No
Enumeration Date:2011-08-28
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY009235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist