Provider Demographics
NPI:1972835197
Name:TIMMER, KELLI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KELLI
Middle Name:
Last Name:TIMMER
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 1:600 NE BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2808
Mailing Address - Country:US
Mailing Address - Phone:816-468-4434
Mailing Address - Fax:816-468-7064
Practice Address - Street 1:600 NE BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2808
Practice Address - Country:US
Practice Address - Phone:816-468-4434
Practice Address - Fax:816-468-7064
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001023396183500000X
KS113358183500000X
TX40489183500000X
FLPS37673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist