Provider Demographics
NPI:1396449161
Name:CRAWHORN, SHELBY JO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:JO
Last Name:CRAWHORN
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 1:2735 CRESCENT HILL DR NE
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IN
Mailing Address - Zip Code:47112-8295
Mailing Address - Country:US
Mailing Address - Phone:812-736-6105
Mailing Address - Fax:
Practice Address - Street 1:4003 KRESGE WAY STE 400
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4652
Practice Address - Country:US
Practice Address - Phone:502-928-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26027876A1835P2201X
KY0201731835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care