Provider Demographics
NPI:1427550946
Name:KEHL, KATY ROSE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATY
Middle Name:ROSE
Last Name:KEHL
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 1:11550 PAGE SERVICE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-3531
Mailing Address - Country:US
Mailing Address - Phone:314-344-9201
Mailing Address - Fax:
Practice Address - Street 1:11550 PAGE SERVICE DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3531
Practice Address - Country:US
Practice Address - Phone:314-344-9201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051300521183500000X
MO2017022612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist