Healthcare Provider Details

I. General information

NPI: 1205641131
Provider Name (Legal Business Name): KEIRAN NOELLE BUELL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 WALKER AVE NW
WALKER MI
49544-9428
US

IV. Provider business mailing address

6428 S 4TH ST
KALAMAZOO MI
49009-9657
US

V. Phone/Fax

Practice location:
  • Phone: 269-321-4310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302415216
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: