Provider Demographics
NPI:1760087498
Name:SIRIPURAPU, KIRAN (RPH)
Entity Type:Individual
Prefix:DR
First Name:KIRAN
Middle Name:
Last Name:SIRIPURAPU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:KIRAN
Other - Middle Name:
Other - Last Name:SIRIPURAPU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:3201 MANTILLA DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1160
Mailing Address - Country:US
Mailing Address - Phone:859-270-3782
Mailing Address - Fax:
Practice Address - Street 1:2000 HARRODSBURG RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1703
Practice Address - Country:US
Practice Address - Phone:859-276-5493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY107641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist