Healthcare Provider Details

I. General information

NPI: 1699688697
Provider Name (Legal Business Name): MICHELLE KERSHAW PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CVS DR
WOONSOCKET RI
02895-6146
US

IV. Provider business mailing address

1 CVS DR BLDG 1
WOONSOCKET RI
02895-6146
US

V. Phone/Fax

Practice location:
  • Phone: 757-532-7655
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19231
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202210506
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number62783
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: