Provider Demographics
NPI:1336226604
Name:KELLEY, CATHERINE LESLIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LESLIE
Last Name:KELLEY
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 1:22948 N 79TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4111
Mailing Address - Country:US
Mailing Address - Phone:480-419-2463
Mailing Address - Fax:
Practice Address - Street 1:22948 N 79TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4111
Practice Address - Country:US
Practice Address - Phone:480-419-2463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9217183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist