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General NPI Number Information
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NPI Number | 1114013331
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Entity Type | Individual
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Provider Name | KELLY LYN MORAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 500 N 5TH ST PHARMACY
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City | HOT SPRINGS
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State | SD
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Zip | 57747-1480
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Country | US
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Telephone | 605-745-2000
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Fax | 605-745-2966
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Provider Business Mailing Address
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Address Line | PO BOX 910
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City | HOT SPRINGS
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State | SD
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Zip | 57747-0910
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Country | US
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Telephone | 605-745-2000
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Fax | 605-745-2066
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS31743
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License Number State | FL
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