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NPI Code Detail

MEDICARE: KELSEY BENTLEY

MEDICARE: KELSEY BENTLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist022232KY

General Provider Information

NPI Number : 1225776206
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY BENTLEY
Provider Business Mailing Address
First Line : 9001 US HIGHWAY 42
Second Line :
City : UNION
State : KY
Zip : 41091-7191
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9001 US HIGHWAY 42
Second Line :
City : UNION
State : KY
Zip : 41091-7191
Country : US
Telephone Number : 859-334-9420
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2022
Last Update Date : 05/20/2022

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Directions to “ KELSEY BENTLEY ” Practice Location

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