Provider Demographics
NPI:1629244207
Name:MUHA, KELLY H (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:H
Last Name:MUHA
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 1:60 SLATE AVE
Mailing Address - Street 2:
Mailing Address - City:OWINGSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40360-2201
Mailing Address - Country:US
Mailing Address - Phone:606-674-6979
Mailing Address - Fax:606-674-2637
Practice Address - Street 1:60 SLATE AVE
Practice Address - Street 2:
Practice Address - City:OWINGSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40360-2201
Practice Address - Country:US
Practice Address - Phone:606-674-6979
Practice Address - Fax:606-674-2637
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist