Provider Demographics
NPI:1902418452
Name:KURKOWSKI, CHELSEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:KURKOWSKI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 S BROADWAY APT 804
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2579
Mailing Address - Country:US
Mailing Address - Phone:606-422-1741
Mailing Address - Fax:
Practice Address - Street 1:9145 BEAUTY RD
Practice Address - Street 2:
Practice Address - City:WARFIELD
Practice Address - State:KY
Practice Address - Zip Code:41267-8302
Practice Address - Country:US
Practice Address - Phone:606-395-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY021546183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist