Provider Demographics
NPI:1255931705
Name:DUNNOCK, KIESHA MONIQUE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KIESHA
Middle Name:MONIQUE
Last Name:DUNNOCK
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 1:2702 N SALISBURY BLVD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-2143
Mailing Address - Country:US
Mailing Address - Phone:410-860-5323
Mailing Address - Fax:410-860-5369
Practice Address - Street 1:2702 N SALISBURY BLVD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-2143
Practice Address - Country:US
Practice Address - Phone:410-860-5323
Practice Address - Fax:410-869-5369
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist