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NPI Code Detail

MEDICARE: ABBY LYNN KEISER PHARMD

MEDICARE: ABBY LYNN KEISER 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
1183500000XPharmacist26023697AIN
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist26023697AIN

General Provider Information

NPI Number : 1275815169
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABBY LYNN KEISER PHARMD
Provider Business Mailing Address
First Line : 10627 DIEBOLD RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-8606
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10627 DIEBOLD RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-8606
Country : US
Telephone Number : 260-470-2665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2011
Last Update Date : 06/28/2012

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