Provider Demographics
NPI:1922783786
Name:SHARP, KAYTLYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAYTLYN
Middle Name:
Last Name:SHARP
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:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:EDMONTON
Mailing Address - State:KY
Mailing Address - Zip Code:42129-0215
Mailing Address - Country:US
Mailing Address - Phone:270-590-3540
Mailing Address - Fax:800-682-2091
Practice Address - Street 1:115 E STOCKTON ST
Practice Address - Street 2:
Practice Address - City:EDMONTON
Practice Address - State:KY
Practice Address - Zip Code:42129-9183
Practice Address - Country:US
Practice Address - Phone:270-432-3051
Practice Address - Fax:800-682-2091
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY023518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist