Provider Demographics
NPI:1679198071
Name:NATIONS, SHARON LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:NATIONS
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:KRMC
Mailing Address - Street 2:540 JETT DRIVE
Mailing Address - City:JACKSON
Mailing Address - State:KY
Mailing Address - Zip Code:41339
Mailing Address - Country:US
Mailing Address - Phone:606-666-6333
Mailing Address - Fax:606-666-6111
Practice Address - Street 1:540 JETT DRIVE
Practice Address - Street 2:PHARMACY
Practice Address - City:JACKSON
Practice Address - State:KY
Practice Address - Zip Code:41339-9622
Practice Address - Country:US
Practice Address - Phone:606-666-6333
Practice Address - Fax:606-666-6111
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0111251835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY011125OtherPHARMACIST