Provider Demographics
NPI:1295338325
Name:TIPTON, VICTORIA CLAIRE
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:CLAIRE
Last Name:TIPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 MOORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-1836
Mailing Address - Country:US
Mailing Address - Phone:859-732-5476
Mailing Address - Fax:
Practice Address - Street 1:214 MOORELAND AVE
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-1836
Practice Address - Country:US
Practice Address - Phone:859-734-5476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist