Healthcare Provider Details

I. General information

NPI: 1720176985
Provider Name (Legal Business Name): KELLY MCNELIS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14TH AND WASHINGTON STREETS CHRISTIANA CARE HEALTH SERVICES-WILMINGTON HOSP ANNEX
WILMINGTON DE
19899-1668
US

IV. Provider business mailing address

WILMINGTON HOSPITAL PO BOX 1668 CHRISTIANA CARE HEALTH SERVICES
WILMINGTON DE
19899-1668
US

V. Phone/Fax

Practice location:
  • Phone: 302-255-1312
  • Fax: 302-255-1374
Mailing address:
  • Phone: 302-255-1312
  • Fax: 302-255-1374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0002387
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: