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General NPI Number Information
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NPI Number | 1336981950
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Entity Type | Individual
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Provider Name | KAELA ELLER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/12/2024
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 5116 W OLIVE AVE
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City | GLENDALE
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State | AZ
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Zip | 85302-4209
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Country | US
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Telephone | 623-937-4771
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Fax |
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Provider Business Mailing Address
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Address Line | 24250 N 23RD AVE UNIT 2049
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City | PHOENIX
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State | AZ
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Zip | 85085-1966
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Country | US
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Telephone | 480-603-8097
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Fax |
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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 | I025206
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License Number State | AZ
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