Provider Demographics
NPI:1245201060
Name:KESSLER, CAROL JEAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JEAN
Last Name:KESSLER
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 1:4623 RIVER SHORE RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-1515
Mailing Address - Country:US
Mailing Address - Phone:757-484-6060
Mailing Address - Fax:
Practice Address - Street 1:SCOTT CENTER ANNEX, NORFOLK NAVAL SHIPYARD
Practice Address - Street 2:BUILDING 1572
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23709-1515
Practice Address - Country:US
Practice Address - Phone:757-953-7462
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist