Provider Demographics
NPI:1639411333
Name:LAMBERT, KELLY PHILLIPS (RPH)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:PHILLIPS
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:LA
Mailing Address - Zip Code:70441-0338
Mailing Address - Country:US
Mailing Address - Phone:225-222-4279
Mailing Address - Fax:225-222-4043
Practice Address - Street 1:6166 HWY 10
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:LA
Practice Address - Zip Code:70441
Practice Address - Country:US
Practice Address - Phone:225-222-4279
Practice Address - Fax:225-222-4043
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15461183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist