Healthcare Provider Details

I. General information

NPI: 1851878854
Provider Name (Legal Business Name): KELLY PASCHEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY MURPHY PHARMD

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 N GRAND BLVD
SAINT LOUIS MO
63106
US

IV. Provider business mailing address

915 N GRAND BLVD JC119
SAINT LOUIS MO
63106-1621
US

V. Phone/Fax

Practice location:
  • Phone: 314-652-4100
  • Fax:
Mailing address:
  • Phone: 314-652-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number2018026752
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2018026752
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number2018026752
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: