Provider Demographics
NPI:1487124434
Name:FLETCHER, REBECCA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:FLETCHER
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 1:170 DR ARLA WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-5454
Mailing Address - Country:US
Mailing Address - Phone:502-277-1425
Mailing Address - Fax:502-277-1427
Practice Address - Street 1:170 DR ARLA WAY STE 105
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40229-5454
Practice Address - Country:US
Practice Address - Phone:502-277-1425
Practice Address - Fax:502-277-1427
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist