Provider Demographics
NPI:1215436985
Name:LEMOND, KIMBERLY SUE (RPH)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SUE
Last Name:LEMOND
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 1:4047 S VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6007
Mailing Address - Country:US
Mailing Address - Phone:775-825-2476
Mailing Address - Fax:775-825-5039
Practice Address - Street 1:4047 S VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6007
Practice Address - Country:US
Practice Address - Phone:775-825-2476
Practice Address - Fax:775-825-5039
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist