Provider Demographics
NPI:1215210687
Name:KELLER, ASHLEY DONELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:DONELLE
Last Name:KELLER
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 1:10530 JOHN W ELLIOTT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-2014
Mailing Address - Country:US
Mailing Address - Phone:800-424-9002
Mailing Address - Fax:
Practice Address - Street 1:10530 JOHN W ELLIOTT DR STE 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-2014
Practice Address - Country:US
Practice Address - Phone:800-424-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist