Healthcare Provider Details

I. General information

NPI: 1235780685
Provider Name (Legal Business Name): TANESHA MICHELLE KEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 CANAL ST
NEW ORLEANS LA
70119-6535
US

IV. Provider business mailing address

3321 FRERET ST
NEW ORLEANS LA
70115-6028
US

V. Phone/Fax

Practice location:
  • Phone: 504-507-3194
  • Fax:
Mailing address:
  • Phone: 310-995-6588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number019338
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: