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NPI Code Detail

MEDICARE: JILLIAN KAY KOEHN PHARMD

MEDICARE: JILLIAN KAY KOEHN PHARMD
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 SpecialistS021722AZ
2183500000XPharmacistS021722AZ

General Provider Information

NPI Number : 1275291726
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN KAY KOEHN PHARMD
Provider Business Mailing Address
First Line : 700 PALMER LN
Second Line :
City : LAKE HAVASU CITY
State : AZ
Zip : 86406-8111
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 80 ACOMA BLVD N
Second Line :
City : LAKE HAVASU CITY
State : AZ
Zip : 86403-6932
Country : US
Telephone Number : 928-680-4449
Fax Number : 928-680-6122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2021
Last Update Date : 06/02/2026

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Directions to “ JILLIAN KAY KOEHN PHARMD” Practice Location

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