Provider Demographics
NPI:1740517846
Name:WILLIAMS, KELLY ELIZABETH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ELIZABETH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2260 LAYTON PARK DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-7763
Mailing Address - Country:US
Mailing Address - Phone:317-554-5781
Mailing Address - Fax:317-941-5024
Practice Address - Street 1:1700 N ILLINOIS ST
Practice Address - Street 2:3RD FLOOR ACT TEAMS
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1316
Practice Address - Country:US
Practice Address - Phone:317-554-5781
Practice Address - Fax:317-941-5024
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022574A1835P1300X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatric