Provider Demographics
NPI:1841573631
Name:FRANCHVILLE, KELLEY BETH
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:BETH
Last Name:FRANCHVILLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6324 QUAIL CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-2926
Mailing Address - Country:US
Mailing Address - Phone:317-786-2653
Mailing Address - Fax:
Practice Address - Street 1:20 S MORTON ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-2102
Practice Address - Country:US
Practice Address - Phone:317-736-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016588A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist