Provider Demographics
NPI:1962973909
Name:MAY, KELSEY LANDGRAF (PHARMD)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:LANDGRAF
Last Name:MAY
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 1:1001 HIGHWAY 98 BYP
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MS
Mailing Address - Zip Code:39429-3741
Mailing Address - Country:US
Mailing Address - Phone:601-731-1266
Mailing Address - Fax:601-731-5127
Practice Address - Street 1:1001 HIGHWAY 98 BYP
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MS
Practice Address - Zip Code:39429-3741
Practice Address - Country:US
Practice Address - Phone:601-731-1266
Practice Address - Fax:601-731-5127
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15790183500000X
MSE-010076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist