Provider Demographics
NPI:1790372704
Name:SPEEGLE, KIMBERLY GEORGE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:GEORGE
Last Name:SPEEGLE
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 1:236 HAMNER DR
Mailing Address - Street 2:
Mailing Address - City:LACEYS SPRING
Mailing Address - State:AL
Mailing Address - Zip Code:35754-6206
Mailing Address - Country:US
Mailing Address - Phone:256-714-8082
Mailing Address - Fax:
Practice Address - Street 1:13574 HIGHWAY 231 431 N STE B
Practice Address - Street 2:
Practice Address - City:HAZEL GREEN
Practice Address - State:AL
Practice Address - Zip Code:35750-8642
Practice Address - Country:US
Practice Address - Phone:256-813-0150
Practice Address - Fax:256-813-0149
Is Sole Proprietor?:No
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist