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NPI Code Detail

MEDICARE: KELLY ANN CHRISTLIEB-MILLER RPH

MEDICARE: KELLY ANN CHRISTLIEB-MILLER RPH
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
1183500000XPharmacist26016015AIN

General Provider Information

NPI Number : 1760086680
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY ANN CHRISTLIEB-MILLER RPH
Provider Business Mailing Address
First Line : 51404 CROOKED OAK DR
Second Line :
City : GRANGER
State : IN
Zip : 46530-7500
Country : US
Telephone Number : 574-532-0870
Fax Number :
Provider Business Practice Location Address
First Line : 130 E CLEVELAND RD
Second Line :
City : GRANGER
State : IN
Zip : 46530-5620
Country : US
Telephone Number : 574-247-2221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2020
Last Update Date : 11/23/2020

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