Provider Demographics
NPI:1184225146
Name:WRIGHT, KELLI P (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:P
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:KELLI
Other - Middle Name:P
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:1143 MASKOKE DR
Mailing Address - Street 2:
Mailing Address - City:CANTONMENT
Mailing Address - State:FL
Mailing Address - Zip Code:32533-5633
Mailing Address - Country:US
Mailing Address - Phone:850-449-0313
Mailing Address - Fax:
Practice Address - Street 1:4600 MOBILE HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-3508
Practice Address - Country:US
Practice Address - Phone:850-455-3620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37053183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist