MEDICARE: DR. MEGAN CHRISTINE KELLY PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P2201X	Ambulatory Care Pharmacist	RPH033614	GA
2	1835P2201X	Ambulatory Care Pharmacist	0000045201	TN

General Provider Information

NPI Number	:	1356049605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGAN CHRISTINE KELLY PHARMD

Provider Business Mailing Address
First Line	:	477 WILMER ST NE UNIT 2314
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-3016
Country	:	US
Telephone Number	:	402-321-5657
Fax Number	:

Provider Business Practice Location Address
First Line	:	477 WILMER ST NE UNIT 2314
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-3016
Country	:	US
Telephone Number	:	402-321-5657
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2023
Last Update Date	:	02/16/2023

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