1760792451 NPI number — MS. LINDSEY MICHELLE KEESLING PHARMD

Table of content: MS. LINDSEY MICHELLE KEESLING PHARMD (NPI 1760792451)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760792451 NPI number — MS. LINDSEY MICHELLE KEESLING PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KEESLING
Provider First Name:
LINDSEY
Provider Middle Name:
MICHELLE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760792451
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7678 GARRICK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FISHERS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46038-1995
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-610-1894
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 CONGRESSIONAL BLVD
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
CARMEL
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46032-5646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-818-1059
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  26023222A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 26023222A . This is a "PHARMACIST LICENSE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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