Healthcare Provider Details

I. General information

NPI: 1932003449
Provider Name (Legal Business Name): KALYN CANTERBURY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 E 450 S STE A
WHITESTOWN IN
46075-8404
US

IV. Provider business mailing address

16598 DOMINION DR
FISHERS IN
46040-8922
US

V. Phone/Fax

Practice location:
  • Phone: 866-725-2546
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26026491A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: