Provider Demographics
NPI:1518554286
Name:FRANCE, KELLI
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:FRANCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 PENNSYLVANIA AVE W STE 1
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-2469
Mailing Address - Country:US
Mailing Address - Phone:814-723-2840
Mailing Address - Fax:
Practice Address - Street 1:348 PENNSYLVANIA AVE W STE 1
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-2469
Practice Address - Country:US
Practice Address - Phone:814-723-2840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP454254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist