Provider Demographics
NPI:1942282033
Name:NEIL, KELLY (PHARM D)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:NEIL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 KARSTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5135
Mailing Address - Country:US
Mailing Address - Phone:615-223-5717
Mailing Address - Fax:
Practice Address - Street 1:500 CHURCH ST
Practice Address - Street 2:STE 650
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37219-2320
Practice Address - Country:US
Practice Address - Phone:615-256-3023
Practice Address - Fax:615-255-3528
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12256183500000X
AL14505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist