Provider Demographics
NPI:1205211323
Name:STEEN, KELSEY OLAF (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:OLAF
Last Name:STEEN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21500 CATAWBA AVE
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-6577
Mailing Address - Country:US
Mailing Address - Phone:704-655-1991
Mailing Address - Fax:704-655-1995
Practice Address - Street 1:21500 CATAWBA AVE
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6577
Practice Address - Country:US
Practice Address - Phone:704-655-1991
Practice Address - Fax:704-655-1995
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25501183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist