Provider Demographics
NPI:1659420248
Name:TURPIN, TRACEY M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:M
Last Name:TURPIN
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 1:233 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-4107
Mailing Address - Country:US
Mailing Address - Phone:606-679-0147
Mailing Address - Fax:606-677-0382
Practice Address - Street 1:647 W HIGHWAY 80
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2897
Practice Address - Country:US
Practice Address - Phone:606-677-1922
Practice Address - Fax:606-677-0382
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54003132Medicaid
4369160001Medicare ID - Type Unspecified