Provider Demographics
NPI:1912674243
Name:KULESA, BRIEE MYLEAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRIEE
Middle Name:MYLEAH
Last Name:KULESA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:BRIEE
Other - Middle Name:MYLEAH
Other - Last Name:LANDIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:949 CAMP ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-3051
Mailing Address - Country:US
Mailing Address - Phone:574-806-2031
Mailing Address - Fax:
Practice Address - Street 1:1040 SIERRA DR STE 1400
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-7240
Practice Address - Country:US
Practice Address - Phone:317-528-7072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028274A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist