Healthcare Provider Details

I. General information

NPI: 1508143413
Provider Name (Legal Business Name): KALPANA LEBO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2011
Last Update Date: 11/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 WESTFIELD RD
NOBLESVILLE IN
46060-1321
US

IV. Provider business mailing address

9513 BELMAR CT
NOBLESVILLE IN
46060-1592
US

V. Phone/Fax

Practice location:
  • Phone: 317-774-8346
  • Fax:
Mailing address:
  • Phone: 260-414-3718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26022379A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: