Provider Demographics
NPI:1760815591
Name:HENRY, KELSEY D (PHARMD)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:D
Last Name:HENRY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:D
Other - Last Name:PURSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:154 CLOVER CIR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-2250
Mailing Address - Country:US
Mailing Address - Phone:304-532-4559
Mailing Address - Fax:
Practice Address - Street 1:228 SHAMROCK LN
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-8380
Practice Address - Country:US
Practice Address - Phone:304-497-3900
Practice Address - Fax:304-645-0156
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC237351835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist