Provider Demographics
NPI:1588492276
Name:KRONSBERG, KELLI A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KELLI
Middle Name:A
Last Name:KRONSBERG
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 1:6720 BOSTON TEA ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-3237
Mailing Address - Country:US
Mailing Address - Phone:541-294-2986
Mailing Address - Fax:
Practice Address - Street 1:6720 BOSTON TEA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-3237
Practice Address - Country:US
Practice Address - Phone:541-294-2986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV202311835I0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835I0206XPharmacy Service ProvidersPharmacistInfectious Diseases