Provider Demographics
NPI:1629621008
Name:HAKE, KELSEY LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:LYNN
Last Name:HAKE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:OFFICES AT BAUM, 5607 BAUM BLVD.
Mailing Address - Street 2:ROOM 303
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206
Mailing Address - Country:US
Mailing Address - Phone:412-624-5240
Mailing Address - Fax:
Practice Address - Street 1:900 MOUNT ROYAL BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15223-1060
Practice Address - Country:US
Practice Address - Phone:412-487-5706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453429183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist