Provider Demographics
NPI:1740866490
Name:KELLER, JESSECA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JESSECA
Middle Name:
Last Name:KELLER
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 1:2999 MCMACKIN RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-2330
Mailing Address - Country:US
Mailing Address - Phone:440-428-1111
Mailing Address - Fax:
Practice Address - Street 1:2999 MCMACKIN RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-2330
Practice Address - Country:US
Practice Address - Phone:440-428-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH033379701835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist