Provider Demographics
NPI:1003149667
Name:SLEAR, KELLY ANNE (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:KELLY
Middle Name:ANNE
Last Name:SLEAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:305 HOSPITAL DR
Mailing Address - Street 2:TATE CENTER, LOWER LEVEL
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5805
Mailing Address - Country:US
Mailing Address - Phone:410-787-4675
Mailing Address - Fax:410-595-1906
Practice Address - Street 1:305 HOSPITAL DR
Practice Address - Street 2:TATE CENTER, LOWER LEVEL
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5805
Practice Address - Country:US
Practice Address - Phone:410-787-4675
Practice Address - Fax:410-595-1906
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist