Provider Demographics
NPI:1093493439
Name:KEESLING, KAITLYN ELISE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:ELISE
Last Name:KEESLING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 W HAINES PASS
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-8460
Mailing Address - Country:US
Mailing Address - Phone:317-833-2377
Mailing Address - Fax:
Practice Address - Street 1:3455 MANN RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46221-2337
Practice Address - Country:US
Practice Address - Phone:317-487-0722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26030328A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist