Provider Demographics
NPI:1972857928
Name:FLYNN, KIMBERLY NACOLE (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:NACOLE
Last Name:FLYNN
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 BLAZER PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509
Mailing Address - Country:US
Mailing Address - Phone:859-629-7117
Mailing Address - Fax:859-685-0161
Practice Address - Street 1:3470 BLAZER PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1200
Practice Address - Country:US
Practice Address - Phone:859-629-7117
Practice Address - Fax:859-685-0161
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0145831835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy