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General NPI Number Information
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NPI Number | 1790068377
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Entity Type | Individual
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Provider Name | AMANDA KERR KELLEY PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 04/05/2016
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Provider Practice Location Address
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Address Line | 922 E MAINST PHARMACY
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City | LAURENS
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State | SC
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Zip | 29360-3616
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Country | US
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Telephone | 864-682-8104
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Fax | 864-683-5760
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Provider Business Mailing Address
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Address Line | 922 E MAINST
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City | LAURENS
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State | SC
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Zip | 29360-3616
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Country | US
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Telephone | 864-682-8104
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Fax | 864-683-5760
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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 | 22014
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP447604
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | SC35905
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License Number State | SC
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