Provider Demographics
NPI:1467013292
Name:SONES, KELLY ROSE (RPH)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ROSE
Last Name:SONES
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 1:210 CAPLOS RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:18661-2948
Mailing Address - Country:US
Mailing Address - Phone:570-579-6504
Mailing Address - Fax:
Practice Address - Street 1:58/60 PUBLIC SQUARE
Practice Address - Street 2:
Practice Address - City:WILKES-BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702
Practice Address - Country:US
Practice Address - Phone:570-284-3756
Practice Address - Fax:570-808-8579
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4533521835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist