Provider Demographics
NPI:1154013183
Name:ROCKETT, KELEON A D J (PHARMD)
Entity type:Individual
Prefix:
First Name:KELEON
Middle Name:A D J
Last Name:ROCKETT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5481
Mailing Address - Country:US
Mailing Address - Phone:603-430-7595
Mailing Address - Fax:
Practice Address - Street 1:1390 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5481
Practice Address - Country:US
Practice Address - Phone:603-430-7595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHCY-01465183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist