Provider Demographics
NPI:1417183948
Name:O'REILLY, KESHA NICHOLAS (PHARMD,RPH)
Entity Type:Individual
Prefix:DR
First Name:KESHA
Middle Name:NICHOLAS
Last Name:O'REILLY
Suffix:
Gender:F
Credentials:PHARMD,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 HARBOUR TOWN DR
Mailing Address - Street 2:
Mailing Address - City:CALVERTON
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1078
Mailing Address - Country:US
Mailing Address - Phone:240-305-3315
Mailing Address - Fax:301-931-0449
Practice Address - Street 1:316 TALBOTT AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4334
Practice Address - Country:US
Practice Address - Phone:240-554-0310
Practice Address - Fax:301-931-0449
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD157661835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist