Provider Demographics
NPI:1215939889
Name:FLANNIGAN, KELLY N (PHARMD)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:N
Last Name:FLANNIGAN
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:PO BOX 26901
Mailing Address - Street 2:ORI-4403
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73190-0001
Mailing Address - Country:US
Mailing Address - Phone:405-271-9039
Mailing Address - Fax:405-271-6002
Practice Address - Street 1:1122 NE 13TH ST
Practice Address - Street 2:ORI-W4403
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-1039
Practice Address - Country:US
Practice Address - Phone:405-271-9039
Practice Address - Fax:405-271-6002
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist