Provider Demographics
NPI:1639681141
Name:STEEVES, KELLY ANN (RPH)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:STEEVES
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 1668
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19899-1668
Mailing Address - Country:US
Mailing Address - Phone:302-320-5600
Mailing Address - Fax:302-421-2718
Practice Address - Street 1:601 DELAWARE AVE FL 2
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1462
Practice Address - Country:US
Practice Address - Phone:302-320-5600
Practice Address - Fax:302-421-2718
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA1-0002999OtherPHARMACIST-IMMUNIZING PHARMACIST