Provider Demographics
NPI:1467747196
Name:CROWLEY, KELLY LYNN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:LYNN
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 ASHLEY AVE
Mailing Address - Street 2:ROOM 616
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-8907
Mailing Address - Country:US
Mailing Address - Phone:843-792-1009
Mailing Address - Fax:843-792-0566
Practice Address - Street 1:150 ASHLEY AVE
Practice Address - Street 2:ROOM 616
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8907
Practice Address - Country:US
Practice Address - Phone:843-792-1009
Practice Address - Fax:843-792-0566
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC010924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist