Healthcare Provider Details

I. General information

NPI: 1154133627
Provider Name (Legal Business Name): KALEY RENEA ORMSBY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 LEROUX ST
DONIPHAN MO
63935-1001
US

IV. Provider business mailing address

144 COUNTY ROAD 277
MYRTLE MO
65778-8342
US

V. Phone/Fax

Practice location:
  • Phone: 573-996-4000
  • Fax:
Mailing address:
  • Phone: 417-270-1525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number2024007840
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: