Healthcare Provider Details

I. General information

NPI: 1366316820
Provider Name (Legal Business Name): KELLY HEY-MILLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1286 LONE OAK BLVD
FORT WAYNE IN
46818-0050
US

IV. Provider business mailing address

1286 LONE OAK BLVD
FORT WAYNE IN
46818-0050
US

V. Phone/Fax

Practice location:
  • Phone: 260-215-5011
  • Fax:
Mailing address:
  • Phone: 260-215-5011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS38028
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: