Provider Demographics
NPI:1346835212
Name:MAY, KELLEY J (PHARMACIST)
Entity Type:Individual
Prefix:MISS
First Name:KELLEY
Middle Name:J
Last Name:MAY
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7190 HIGHWAY 165
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-3302
Mailing Address - Country:US
Mailing Address - Phone:318-649-0825
Mailing Address - Fax:
Practice Address - Street 1:7190 HIGHWAY 165
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-3302
Practice Address - Country:US
Practice Address - Phone:318-649-0825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16105183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist