Provider Demographics
NPI:1528398641
Name:STUART, KELLY KEMP (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:KEMP
Last Name:STUART
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 LEE BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7298
Mailing Address - Country:US
Mailing Address - Phone:662-719-4279
Mailing Address - Fax:205-995-5836
Practice Address - Street 1:1100 LEE BRANCH LN
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-7298
Practice Address - Country:US
Practice Address - Phone:662-719-4279
Practice Address - Fax:205-995-5836
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-092291835G0303X, 1835P0018X
MSE092291835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy