Provider Demographics
NPI:1689957953
Name:MINOR, KIMBERLY H (RPH)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:H
Last Name:MINOR
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 1:285 DUNLOP BLVD SW STE A
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35824-1120
Mailing Address - Country:US
Mailing Address - Phone:256-258-0380
Mailing Address - Fax:
Practice Address - Street 1:285 DUNLOP BLVD SW STE A
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35824-1120
Practice Address - Country:US
Practice Address - Phone:256-258-0380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12735183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist