Provider Demographics
NPI:1033541396
Name:KELLER, ANDREW (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:KELLER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 RICHARD JONES RD
Mailing Address - Street 2:APT Q14
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2804
Mailing Address - Country:US
Mailing Address - Phone:740-357-1111
Mailing Address - Fax:
Practice Address - Street 1:2011 RICHARD JONES RD
Practice Address - Street 2:APT Q14
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2804
Practice Address - Country:US
Practice Address - Phone:740-357-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37682183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist