Provider Demographics
NPI:1396017182
Name:LAMAN, KELLY GAULT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:GAULT
Last Name:LAMAN
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 1:9390 S COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-5256
Mailing Address - Country:US
Mailing Address - Phone:303-683-1159
Mailing Address - Fax:
Practice Address - Street 1:9390 S COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-5256
Practice Address - Country:US
Practice Address - Phone:303-683-1159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist