Healthcare Provider Details

I. General information

NPI: 1659962199
Provider Name (Legal Business Name): KELSEY ROSE EVAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4741 CHAPMANS RD
ALLENTOWN PA
18104-9015
US

IV. Provider business mailing address

601 W SPRUCE ST APT C1
PERKASIE PA
18944-1373
US

V. Phone/Fax

Practice location:
  • Phone: 484-201-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP456353
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: