Provider Demographics
NPI:1578914198
Name:OWEN, SYDNEY RYAN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:RYAN
Last Name:OWEN
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 1:3848 PINE RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40514-1770
Mailing Address - Country:US
Mailing Address - Phone:859-749-5796
Mailing Address - Fax:
Practice Address - Street 1:110 TOWNE CENTER DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-2027
Practice Address - Country:US
Practice Address - Phone:859-288-2172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY018579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist