Provider Demographics
NPI:1386140929
Name:HELLMANN, KEISHA MEEHAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEISHA
Middle Name:MEEHAN
Last Name:HELLMANN
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 1:1602 EDGINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ELDORA
Mailing Address - State:IA
Mailing Address - Zip Code:50627-1626
Mailing Address - Country:US
Mailing Address - Phone:641-858-3567
Mailing Address - Fax:641-858-3189
Practice Address - Street 1:1602 EDGINGTON AVE
Practice Address - Street 2:
Practice Address - City:ELDORA
Practice Address - State:IA
Practice Address - Zip Code:50627-1626
Practice Address - Country:US
Practice Address - Phone:641-858-3567
Practice Address - Fax:641-858-3189
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23072183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist