Provider Demographics
NPI:1154603298
Name:ELDER, KIMBERLY (PHARMD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:ELDER
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 1:830 GARDENBROOK CIRCLE
Mailing Address - Street 2:APARTMENT K
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-4657
Mailing Address - Country:US
Mailing Address - Phone:502-797-5845
Mailing Address - Fax:
Practice Address - Street 1:830 GARDENBROOK CIR APT K
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-4657
Practice Address - Country:US
Practice Address - Phone:502-797-5845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023549A1835P1200X
KY0149891835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy