Provider Demographics
NPI:1942511787
Name:BINIAK, KELLY JEANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:JEANNE
Last Name:BINIAK
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 1:3330 MARTIN LUTHER KING JR PKWY
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-5672
Mailing Address - Country:US
Mailing Address - Phone:515-255-6213
Mailing Address - Fax:515-255-8806
Practice Address - Street 1:3330 MARTIN LUTHER KING JR PKWY
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5672
Practice Address - Country:US
Practice Address - Phone:515-255-6213
Practice Address - Fax:515-255-8806
Is Sole Proprietor?:No
Enumeration Date:2010-06-26
Last Update Date:2010-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21071183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist