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General NPI Number Information
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NPI Number | 1902213101
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Entity Type | Individual
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Provider Name | KELLIE BUSBY PHARMD, BCPP
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Gender | Female
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Dates
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Enumeration Date | 07/20/2014
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 1623 N APACHE DR
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City | CHANDLER
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State | AZ
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Zip | 85224-8620
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Country | US
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Telephone | 480-477-4468
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Fax |
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Provider Business Mailing Address
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Address Line | 1623 N APACHE DR
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City | CHANDLER
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State | AZ
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Zip | 85224-8620
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Country | US
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Telephone | 480-477-4468
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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 | S020576
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | S020576
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License Number State | AZ
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