Healthcare Provider Details

I. General information

NPI: 1538167085
Provider Name (Legal Business Name): KELLY HESTER PHARMD, BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 W SOUTH BLVD
MONTGOMERY AL
36105-3019
US

IV. Provider business mailing address

2219 WATERCREST DR
AUBURN AL
36830-4118
US

V. Phone/Fax

Practice location:
  • Phone: 888-435-7626
  • Fax: 334-281-1970
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number13406
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: