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NPI Code Detail

MEDICARE: CHRISTINE ANN KELDSEN PHARM. D.

MEDICARE:   CHRISTINE ANN KELDSEN  PHARM. D.
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
1183500000XPharmacist26024714AIN

General Provider Information

NPI Number : 1366788366
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE ANN KELDSEN PHARM. D.
Provider Business Mailing Address
First Line : 8429 CABIN CREEK DR APT E
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46237-6327
Country : US
Telephone Number : 307-371-8788
Fax Number :
Provider Business Practice Location Address
First Line : 4850 E SOUTHPORT RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46237-3321
Country : US
Telephone Number : 317-787-6285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2012
Last Update Date : 12/19/2012

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