Provider Demographics
NPI:1669500906
Name:GORMLEY, LINDA SUE (RPH)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUE
Last Name:GORMLEY
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 1:1017 APPLEBLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:VILLA HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-5348
Mailing Address - Country:US
Mailing Address - Phone:859-331-2236
Mailing Address - Fax:
Practice Address - Street 1:2446 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:CRESCENT SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:41017-1400
Practice Address - Country:US
Practice Address - Phone:859-341-1660
Practice Address - Fax:859-344-4142
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist