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General NPI Number Information
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NPI Number | 1770836231
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Entity Type | Individual
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Provider Name | DR. NEELY KELLEHER
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Gender | Female
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 370 S ILLINOIS AVE
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City | OAK RIDGE
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State | TN
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Zip | 37830-6221
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Country | US
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Telephone | 865-483-7164
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Fax |
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Provider Business Mailing Address
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Address Line | 854 TRENT LN
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City | KNOXVILLE
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State | TN
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Zip | 37922-4197
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Country | US
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Telephone | 865-671-1695
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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 | 29638
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 29638
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License Number State | TN
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