Provider Demographics
NPI:1891331989
Name:GESELLCHEN-WALKER, PAMELA (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:GESELLCHEN-WALKER
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 1:5025 W 71ST ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-2102
Mailing Address - Country:US
Mailing Address - Phone:317-347-8488
Mailing Address - Fax:317-347-8489
Practice Address - Street 1:5025 W 71ST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-2102
Practice Address - Country:US
Practice Address - Phone:317-347-8488
Practice Address - Fax:317-347-8489
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-23
Last Update Date:2019-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26025046A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist