Provider Demographics
NPI:1427331305
Name:KELLY, ROSA IANNONE (PHARMD/RPH)
Entity type:Individual
Prefix:DR
First Name:ROSA
Middle Name:IANNONE
Last Name:KELLY
Suffix:
Gender:F
Credentials:PHARMD/RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 CANTON CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3969
Mailing Address - Country:US
Mailing Address - Phone:443-310-6272
Mailing Address - Fax:
Practice Address - Street 1:6675 MARIE CURIE DR
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6457
Practice Address - Country:US
Practice Address - Phone:410-423-4059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist