Provider Demographics
NPI:1154133627
Name:KEPPLINGER, KALEY RENEA
Entity type:Individual
Prefix:
First Name:KALEY
Middle Name:RENEA
Last Name:KEPPLINGER
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 1:144 COUNTY ROAD 277
Mailing Address - Street 2:
Mailing Address - City:MYRTLE
Mailing Address - State:MO
Mailing Address - Zip Code:65778-8342
Mailing Address - Country:US
Mailing Address - Phone:417-270-1525
Mailing Address - Fax:
Practice Address - Street 1:110 LEROUX ST
Practice Address - Street 2:
Practice Address - City:DONIPHAN
Practice Address - State:MO
Practice Address - Zip Code:63935-1001
Practice Address - Country:US
Practice Address - Phone:573-996-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240078401835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist