Provider Demographics
NPI:1992300974
Name:KELLEY, MEGAN ELIZABETH (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:KELLEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6025 MOBILE HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-1234
Mailing Address - Country:US
Mailing Address - Phone:850-458-9818
Mailing Address - Fax:850-458-9818
Practice Address - Street 1:6025 MOBILE HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-1234
Practice Address - Country:US
Practice Address - Phone:850-458-9818
Practice Address - Fax:850-458-9818
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist