Provider Demographics
NPI:1063009538
Name:FEHER, KELLY STEPHENS (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:STEPHENS
Last Name:FEHER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 MAPLE AVE # 910
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06114-2700
Mailing Address - Country:US
Mailing Address - Phone:860-956-7107
Mailing Address - Fax:
Practice Address - Street 1:908 MAPLE AVE # 910
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-2700
Practice Address - Country:US
Practice Address - Phone:860-956-7107
Practice Address - Fax:860-956-8301
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8509183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist