Provider Demographics
NPI:1720176985
Name:MCNELIS, KELLY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:MCNELIS
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:WILMINGTON HOSPITAL PO BOX 1668
Mailing Address - Street 2:CHRISTIANA CARE HEALTH SERVICES
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19899-1668
Mailing Address - Country:US
Mailing Address - Phone:302-255-1312
Mailing Address - Fax:302-255-1374
Practice Address - Street 1:14TH AND WASHINGTON STREETS
Practice Address - Street 2:CHRISTIANA CARE HEALTH SERVICES-WILMINGTON HOSP ANNEX
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19899-1668
Practice Address - Country:US
Practice Address - Phone:302-255-1312
Practice Address - Fax:302-255-1374
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist